{ "schemaVersion": "deck-intelligence.v1", "id": "019dd923-622c-750b-8b9a-40e2965928db", "slug": "e5bffbaac707", "title": "TransMedics (TMDX)", "subtitle": "Scorpion Capital · 2025-01", "author": "Scorpion Capital", "date": "2025-01-10 00:00:00", "pageCount": 342, "kind": "research-note", "orientation": "landscape", "aspectRatio": 1.3333334, "targetCompany": "TransMedics", "targetTicker": "TMDX", "document": { "id": "019dd923-622c-750b-8b9a-40e2965928db", "slug": "e5bffbaac707", "title": "TransMedics (TMDX)", "rawTitle": "TMDX", "authorId": "58_Scorpion_Capital", "authorName": "Scorpion Capital", "authorDisplay": "Scorpion Capital", "kind": { "slug": "research-note", "label": "Research note" }, "sourceType": { "slug": "short_seller", "label": "Short seller" }, "fileName": "TMDX.pdf", "sourceUrl": "http://www.scorpioncapital.com", "sourceDate": "2025-01-10 00:00:00", "presentationDate": "2025-01-10 00:00:00", "ingestedAt": "2026-04-22 22:33:12+00", "status": "ready", "pageCount": 342, "orientation": "landscape", "aspectRatio": 1.3333334, "targetCompany": "TransMedics", "targetTicker": "TMDX", "metadata": { "local_root": "/tmp/legacy-images/e5bffbaac707", "activist_firm": "Scorpion Capital", "origin_corpus": "contrarian", "extraction_seconds": 203.3482141494751 } }, "coverage": { "pageCount": 342, "pagesIndexed": 342, "pagesWithImages": 342, "pagesWithMetadata": 342, "imageCoveragePct": 100, "metadataCoveragePct": 100, "componentCount": 2155, "chartCount": 4, "metricSlides": 0, "toolMatches": 40, "documentToolMatches": 5, "frameworkMatches": 143, "arcMatches": 1, "beatMatches": 3, "loopMatches": 0, "patternMatches": 0, "storymakersMatch": false, "scoreAvailable": false, "reviewAvailable": false, "activistThesisAvailable": true, "pitchdeckMetadataAvailable": false, "pitchdeckProfileAvailable": false }, "blocks": [], "matches": { "arcs": [ { "arc": { "name": "Overcoming the Monster", "slug": "overcoming-monster", "status": "active", "bestFor": "Competitive positioning, rallying teams", "canonId": "019dd956-6339-76ac-9cbf-4b377c3aa89e", "version": 1, "bodyDocId": "019df22a-2356-73eb-8061-d8c81dc0aa49", "structure": "The Monster -> The Call -> The Struggle -> The Victory -> The New Order", "description": null, "familyLabel": null, "categoryName": "Booker's 7 Plots", "categorySlug": "booker-s-7-plots" }, "matchId": "d22e2123-5207-45f3-8f91-8fe159736ca7", "evidence": "The document follows a narrative arc of uncovering the 'monster' of TransMedics Group Inc.'s alleged fraudulent practices.", "isPrimary": true, "confidence": 0.8, "extraction": { "at": "2026-07-17 03:21:10.482348+00", "model": "or:meta-llama/llama-4-scout", "runId": null, "seconds": null, "promptVersion": "doc-narrative-v1" } } ], "beats": [ { "to": 20, "arc": { "name": "Overcoming the Monster", "slug": "overcoming-monster", "status": "active", "bestFor": "Competitive positioning, rallying teams", "canonId": "019dd956-6339-76ac-9cbf-4b377c3aa89e", "version": 1, "bodyDocId": "019df22a-2356-73eb-8061-d8c81dc0aa49", "structure": "The Monster -> The Call -> The Struggle -> The Victory -> The New Order", "description": null, "familyLabel": null, "categoryName": "Booker's 7 Plots", "categorySlug": "booker-s-7-plots" }, "from": 11, "name": "Critique of TransMedics Group Inc.", "beatId": "c9fa8ec4-9e59-45eb-9317-74367547147c", "matchId": "d22e2123-5207-45f3-8f91-8fe159736ca7", "beatType": null, "evidence": "The section presents a critical analysis of TransMedics Group Inc.'s practices and leadership.", "position": 0, "isPrimaryArc": true, "parentBeatType": null, "alignedBlockIds": null, "matchConfidence": 0.8 }, { "to": 30, "arc": { "name": "Overcoming the Monster", "slug": "overcoming-monster", "status": "active", "bestFor": "Competitive positioning, rallying teams", "canonId": "019dd956-6339-76ac-9cbf-4b377c3aa89e", "version": 1, "bodyDocId": "019df22a-2356-73eb-8061-d8c81dc0aa49", "structure": "The Monster -> The Call -> The Struggle -> The Victory -> The New Order", "description": null, "familyLabel": null, "categoryName": "Booker's 7 Plots", "categorySlug": "booker-s-7-plots" }, "from": 12, "name": "Exposure of Contradictions", "beatId": "072007ec-5fd3-4416-b852-0e181a364efd", "matchId": "d22e2123-5207-45f3-8f91-8fe159736ca7", "beatType": null, "evidence": "The section highlights contradictions in TransMedics Group Inc.'s statements and actions.", "position": 1, "isPrimaryArc": true, "parentBeatType": null, "alignedBlockIds": null, "matchConfidence": 0.8 }, { "to": 9, "arc": { "name": "Overcoming the Monster", "slug": "overcoming-monster", "status": "active", "bestFor": "Competitive positioning, rallying teams", "canonId": "019dd956-6339-76ac-9cbf-4b377c3aa89e", "version": 1, "bodyDocId": "019df22a-2356-73eb-8061-d8c81dc0aa49", "structure": "The Monster -> The Call -> The Struggle -> The Victory -> The New Order", "description": null, "familyLabel": null, "categoryName": "Booker's 7 Plots", "categorySlug": "booker-s-7-plots" }, "from": 3, "name": "Testimonials from Industry Experts", "beatId": "2ce2729c-3fa0-4258-b23a-c05ff53032bc", "matchId": "d22e2123-5207-45f3-8f91-8fe159736ca7", "beatType": null, "evidence": "The section presents testimonials from experts and industry professionals criticizing TransMedics Group Inc.", "position": 2, "isPrimaryArc": true, "parentBeatType": null, "alignedBlockIds": null, "matchConfidence": 0.8 } ], "loops": [], "tools": [ { "tool": { "name": "CEO quote contradiction", "slug": "ceo-quote-contradiction", "status": "active", "bestFor": "When management credibility is the lever", "canonId": "019dd9e1-52e9-717f-8454-93e627563ed6", "version": 1, "bodyDocId": "019dd9a1-8296-720d-8f51-da76937f9415", "description": "You reproduce management's own words — verbatim, with source and date — and\nthen place them next to the outcome that contradicts them. The CEO built\nthe rope; you put it around their own neck.", "familyLabel": null, "categoryName": null, "categorySlug": null }, "agent": null, "layer": "document", "agents": null, "matchId": "2890e561-c550-4328-b2df-22553b603c7a", "evidence": null, "pageRefs": null, "priority": null, "whenToUse": "When management credibility is the lever", "confidence": null, "extraction": { "at": "2026-04-29 12:07:50.209813+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": null, "whyItWorks": "- **Maximum credibility**: no adjective you could write is as damning as the\n target's own prior statement.\n- **No rebuttal path**: management can't argue they didn't say it.\n- **It forces accountability onto a person**, not an institution — even if\n you aren't explicitly naming a villain elsewhere.\n- **Reporters amplify it**. A CEO-quote-contradiction slide is quotable,\n which means it lands in WSJ/FT/Bloomberg coverage.", "antipattern": null, "cardinality": null, "narrativePurpose": null }, { "tool": { "name": "Peer gap chart", "slug": "peer-gap", "status": "active", "bestFor": "When relative underperformance is the core argument", "canonId": "019dd9e1-54f1-775a-94a1-d5cf3bb75abf", "version": 1, "bodyDocId": "019dd9a1-8653-7748-9050-807f067196c3", "description": "A single visual that benchmarks the target against its best-in-class peers on\na single quantitative KPI — and shows the target losing. The gap is the\npunchline.", "familyLabel": null, "categoryName": null, "categorySlug": null }, "agent": null, "layer": "document", "agents": null, "matchId": "d4f87a7f-65b6-41f7-9611-62f5312b8237", "evidence": null, "pageRefs": null, "priority": null, "whenToUse": "When relative underperformance is the core argument", "confidence": null, "extraction": { "at": "2026-04-29 12:07:50.209813+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": null, "whyItWorks": "- It's the **most credible claim in the deck** because it's arithmetic, not\n opinion.\n- It's immediately **actionable** — close this gap and value accrues.\n- It **pre-empts the \"context is different\" defence** by pitting the target\n against direct peers in the same category.", "antipattern": null, "cardinality": null, "narrativePurpose": null }, { "tool": { "name": "Sum of parts", "slug": "sum-of-parts", "status": "active", "bestFor": "For breakup / spin-off theses", "canonId": "019dd9e1-51e5-73ad-9d1e-e77d4afe3125", "version": 1, "bodyDocId": "019df22a-9ecd-71db-8fa1-5f5eff36697f", "description": "You break the target into its constituent businesses or asset classes, value\neach separately against its own peer set, and show that the total is\nmaterially greater than the current market capitalisation. The \"gap\" is the\nconglomerate discount — or worse, accounting opacity hiding a crown-jewel\nasset.", "familyLabel": null, "categoryName": null, "categorySlug": null }, "agent": null, "layer": "document", "agents": null, "matchId": "9dd5b67d-05e4-451f-84ff-de9355efeafa", "evidence": null, "pageRefs": null, "priority": null, "whenToUse": "For breakup / spin-off theses", "confidence": null, "extraction": { "at": "2026-04-29 12:07:50.209813+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": null, "whyItWorks": "- It forces the market to confront **mismatched valuation multiples**:\n \"this company trades like X but owns Y, which trades at", "antipattern": null, "cardinality": null, "narrativePurpose": null }, { "tool": { "name": "Villain naming", "slug": "villain-naming", "status": "active", "bestFor": "When governance or specific decisions are the core thesis", "canonId": "019dd9e1-55a4-74db-9314-0ced4cd46cd2", "version": 1, "bodyDocId": "019dd9a1-88f1-72ad-8f4e-56ec29d7b369", "description": "You identify a **specific person** responsible for the target's underperformance\nor the behaviour you want changed — and name them. Not \"management\" or \"the\nboard\". A named executive or director with a specific failure attributable to\nthem.", "familyLabel": null, "categoryName": null, "categorySlug": null }, "agent": null, "layer": "document", "agents": null, "matchId": "f9a65061-b09f-444d-8427-253e50756fa7", "evidence": "Waleed Hassanein (CEO); also Tamer Khayal (COO), Magdy Attia, and Amira Hassanein (CEO's sister, lung program)", "pageRefs": null, "priority": null, "whenToUse": "When governance or specific decisions are the core thesis", "confidence": null, "extraction": { "at": "2026-04-29 12:07:50.209813+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": null, "whyItWorks": "- **Accountability needs a face.** Voters (shareholders, regulators,\n journalists) act faster against people than institutions.\n- **Credibility rises with specificity.** \"The CFO has repeatedly missed\n guidance\" > \"Management has missed guidance\".\n- It **pre-empts evasion**. An individual can be removed; an abstraction\n cannot.\n- It **forces the target to respond personally** — and their defensive\n response usually generates more attention for your thesis.", "antipattern": null, "cardinality": null, "narrativePurpose": null }, { "tool": { "name": "Villain slide", "slug": "villain-slide", "status": "active", "bestFor": "In activist decks where the personality matters", "canonId": "019dd9e1-518c-7404-976a-5be5a517b659", "version": 1, "bodyDocId": null, "description": "A dedicated slide presenting the named villain visually", "familyLabel": null, "categoryName": null, "categorySlug": null }, "agent": null, "layer": "document", "agents": null, "matchId": "63012885-db40-4de0-9239-d570c2c6eef7", "evidence": null, "pageRefs": null, "priority": null, "whenToUse": "In activist decks where the personality matters", "confidence": null, "extraction": { "at": "2026-04-29 12:07:50.209813+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": null, "whyItWorks": "Makes the antagonist concrete", "antipattern": null, "cardinality": null, "narrativePurpose": null }, { "tool": { "name": "Call to action", "slug": "call-to-action", "status": "active", "bestFor": null, "canonId": "019dd9e1-4bbb-702a-9ead-82daf188bb7c", "version": 1, "bodyDocId": null, "description": "Explicit prescription of what the audience should do next.", "familyLabel": null, "categoryName": null, "categorySlug": null }, "agent": null, "layer": "slide", "agents": null, "matchId": "58e95065-0c9b-4577-a7f4-bf7aac6b1818", "evidence": "callout/primary: We are shortly filing a Citizen Petition with the FDA requesting suspension of PMA (Premarket Approval) of TransMedics Organ Care System (OCS), in conjunction with a public letter to members of Congress probing", "pageRefs": null, "priority": null, "whenToUse": null, "confidence": 0.7, "extraction": { "at": "2026-07-16 23:10:27.483934+00", "model": "or:meta-llama/llama-4-scout", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 1, "whyItWorks": null, "antipattern": null, "cardinality": "common", "narrativePurpose": null }, { "tool": { "name": "Slide recipe: Cover", "slug": "cover-slide", "status": "active", "bestFor": null, "canonId": "019df269-2a08-767d-9128-e7431e6fe8a3", "version": 1, "bodyDocId": "019df269-29e5-7738-b5fa-6892e5dc8e65", "description": "The first ten seconds. Build it deliberately.", "familyLabel": "slide-recipe", "categoryName": "Slide", "categorySlug": "slide" }, "agent": "designer", "layer": "slide", "agents": [ "designer" ], "matchId": "685d2fc8-8cb3-4e0a-94df-34f1e471c521", "evidence": "type: cover", "pageRefs": null, "priority": null, "whenToUse": null, "confidence": 0.9, "extraction": { "at": "2026-07-16 23:10:27.450203+00", "model": "or:meta-llama/llama-4-scout", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 1, "whyItWorks": null, "antipattern": null, "cardinality": null, "narrativePurpose": null }, { "tool": { "name": "Emotional Appeal", "slug": "emotional-appeal", "status": "active", "bestFor": null, "canonId": "019dd956-bde9-7668-8be7-0097678fec59", "version": 1, "bodyDocId": null, "description": "Connecting to audience feelings rather than just logic", "familyLabel": null, "categoryName": "Slide", "categorySlug": "slide" }, "agent": "Storyteller", "layer": "slide", "agents": [ "Storyteller" ], "matchId": "e4d974f7-ac1b-4241-8084-b99d3932b47c", "evidence": "quote: \"It's like racketeering or something, right? That's what it feels like...I'm sure other surgeons have used some pretty dramatic words...they're playing like mafia-style...very deliberate and a thug-style way of getting business.\"", "pageRefs": null, "priority": null, "whenToUse": null, "confidence": 0.7, "extraction": { "at": "2026-07-16 23:10:27.581897+00", "model": "or:meta-llama/llama-4-scout", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 3, "whyItWorks": null, "antipattern": null, "cardinality": null, "narrativePurpose": null }, { "tool": { "name": "Anaphora", "slug": "anaphora", "status": "active", "bestFor": null, "canonId": "019dd956-9fee-74aa-a920-078aa44132c0", "version": 1, "bodyDocId": null, "description": "Repeating words at the beginning of successive clauses for rhythm", "familyLabel": null, "categoryName": "Loop", "categorySlug": "loop" }, "agent": "Storyteller", "layer": "slide", "agents": [ "Storyteller" ], "matchId": "bf70f3c4-9369-439e-8f4f-d22471697ab5", "evidence": "quote/testimonial: \"If that gets revealed, if that gets exposed in any way, that's curtains...I have known of some sites in our region that would get these kinds of calls...this kind of hotline for organs...it allowed them consequently...\".", "pageRefs": null, "priority": null, "whenToUse": null, "confidence": 0.7, "extraction": { "at": "2026-07-16 23:10:27.646681+00", "model": "or:meta-llama/llama-4-scout", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 4, "whyItWorks": null, "antipattern": null, "cardinality": null, "narrativePurpose": null }, { "tool": { "name": "Villain slide", "slug": "villain-slide", "status": "active", "bestFor": "In activist decks where the personality matters", "canonId": "019dd9e1-518c-7404-976a-5be5a517b659", "version": 1, "bodyDocId": null, "description": "A dedicated slide presenting the named villain visually", "familyLabel": null, "categoryName": null, "categorySlug": null }, "agent": null, "layer": "slide", "agents": null, "matchId": "bff3e90b-8e58-4bbc-bcd7-72cb97b6603c", "evidence": "The slide presents a strongly negative view of a company, using phrases like 'I cannot stand working with them' and 'it feels like I'm talking to a used car salesman', which are typical characteristics of a villain slide.", "pageRefs": null, "priority": null, "whenToUse": "In activist decks where the personality matters", "confidence": 0.9, "extraction": { "at": "2026-07-16 23:10:25.483959+00", "model": "or:meta-llama/llama-4-scout", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 5, "whyItWorks": "Makes the antagonist concrete", "antipattern": null, "cardinality": null, "narrativePurpose": null }, { "tool": { "name": "Villain slide", "slug": "villain-slide", "status": "active", "bestFor": "In activist decks where the personality matters", "canonId": "019dd9e1-518c-7404-976a-5be5a517b659", "version": 1, "bodyDocId": null, "description": "A dedicated slide presenting the named villain visually", "familyLabel": null, "categoryName": null, "categorySlug": null }, "agent": null, "layer": "slide", "agents": null, "matchId": "d6828756-6a48-486b-ae5e-cb3720dccf36", "evidence": "This slide also presents a negative testimonial, which could be seen as part of a villain narrative, but it's less clear than slide 1.", "pageRefs": null, "priority": null, "whenToUse": "In activist decks where the personality matters", "confidence": 0.8, "extraction": { "at": "2026-07-16 23:10:25.571347+00", "model": "or:meta-llama/llama-4-scout", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 6, "whyItWorks": "Makes the antagonist concrete", "antipattern": null, "cardinality": null, "narrativePurpose": null }, { "tool": { "name": "Villain slide", "slug": "villain-slide", "status": "active", "bestFor": "In activist decks where the personality matters", "canonId": "019dd9e1-518c-7404-976a-5be5a517b659", "version": 1, "bodyDocId": null, "description": "A dedicated slide presenting the named villain visually", "familyLabel": null, "categoryName": null, "categorySlug": null }, "agent": null, "layer": "slide", "agents": null, "matchId": "b673fb97-0720-4a72-94f7-1cae8c3b372f", "evidence": "The slide explicitly states 'TransMedics is going to die', which could be seen as a strong negative statement typical of a villain slide.", "pageRefs": null, "priority": null, "whenToUse": "In activist decks where the personality matters", "confidence": 0.8, "extraction": { "at": "2026-07-16 23:10:25.660092+00", "model": "or:meta-llama/llama-4-scout", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 7, "whyItWorks": "Makes the antagonist concrete", "antipattern": null, "cardinality": null, "narrativePurpose": null }, { "tool": { "name": "Anadiplosis", "slug": "anadiplosis", "status": "active", "bestFor": null, "canonId": "019dd956-a0a5-75f9-a98c-7b7d8ee377a1", "version": 1, "bodyDocId": null, "description": "Ending one clause with a word that begins the next", "familyLabel": null, "categoryName": "Loop", "categorySlug": "loop" }, "agent": "Storyteller", "layer": "slide", "agents": [ "Storyteller" ], "matchId": "4293e050-da7b-4ee3-8417-343e27d91a14", "evidence": "The slide uses repetition of negative quotes about the CEO and the company, which is a rhetorical device similar to anadiplosis.", "pageRefs": null, "priority": null, "whenToUse": null, "confidence": 0.7, "extraction": { "at": "2026-07-16 23:10:25.877674+00", "model": "or:meta-llama/llama-4-scout", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 17, "whyItWorks": null, "antipattern": null, "cardinality": null, "narrativePurpose": null }, { "tool": { "name": "Villain slide", "slug": "villain-slide", "status": "active", "bestFor": "In activist decks where the personality matters", "canonId": "019dd9e1-518c-7404-976a-5be5a517b659", "version": 1, "bodyDocId": null, "description": "A dedicated slide presenting the named villain visually", "familyLabel": null, "categoryName": null, "categorySlug": null }, "agent": null, "layer": "slide", "agents": null, "matchId": "e5695b61-d5b6-4930-a3c8-778c9b429d0e", "evidence": "The slide presents a critical view of TransMedics' CEO, describing him as \"an arrogant prick\" and the company as \"dishonest\", which aligns with the characteristics of a villain slide.", "pageRefs": null, "priority": null, "whenToUse": "In activist decks where the personality matters", "confidence": 0.9, "extraction": { "at": "2026-07-16 23:10:25.845382+00", "model": "or:meta-llama/llama-4-scout", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 17, "whyItWorks": "Makes the antagonist concrete", "antipattern": null, "cardinality": null, "narrativePurpose": null }, { "tool": { "name": "Thesis archetype", "slug": "thesis-archetype", "status": "active", "bestFor": null, "canonId": "019dd9e1-4b0b-7428-9b26-f171d1e753fb", "version": 1, "bodyDocId": null, "description": "A canonical investment / activist thesis shape (breakup, fraud, governance).", "familyLabel": null, "categoryName": null, "categorySlug": null }, "agent": null, "layer": "slide", "agents": null, "matchId": "3afaf9e7-ca18-478b-ac44-f28104b2bee5", "evidence": "Part 1. TransMedics National OCS Program (NOP): an unsustainable, anti-competitive scheme based on what we believe to be coercive tying, price extortion, and retaliation.", "pageRefs": null, "priority": null, "whenToUse": null, "confidence": 0.7, "extraction": { "at": "2026-07-16 23:10:27.495235+00", "model": "or:meta-llama/llama-4-scout", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 41, "whyItWorks": null, "antipattern": null, "cardinality": "optional", "narrativePurpose": null }, { "tool": { "name": "Anadiplosis", "slug": "anadiplosis", "status": "active", "bestFor": null, "canonId": "019dd956-a0a5-75f9-a98c-7b7d8ee377a1", "version": 1, "bodyDocId": null, "description": "Ending one clause with a word that begins the next", "familyLabel": null, "categoryName": "Loop", "categorySlug": "loop" }, "agent": "Storyteller", "layer": "slide", "agents": [ "Storyteller" ], "matchId": "fd95669a-cb48-4581-b292-6658ea7cc777", "evidence": "The repetition of 'I think the government is going to come in, and they're really going to shake this up' emphasizes the predicted regulatory action.", "pageRefs": null, "priority": null, "whenToUse": null, "confidence": 0.7, "extraction": { "at": "2026-07-16 23:10:31.773404+00", "model": "or:meta-llama/llama-4-scout", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 114, "whyItWorks": null, "antipattern": null, "cardinality": null, "narrativePurpose": null }, { "tool": { "name": "Villain slide", "slug": "villain-slide", "status": "active", "bestFor": "In activist decks where the personality matters", "canonId": "019dd9e1-518c-7404-976a-5be5a517b659", "version": 1, "bodyDocId": null, "description": "A dedicated slide presenting the named villain visually", "familyLabel": null, "categoryName": null, "categorySlug": null }, "agent": null, "layer": "slide", "agents": null, "matchId": "e445994b-3853-41b9-9212-3d9098018ca5", "evidence": "The slide presents a critical view of TransMedics, labeling it as a 'creature of this abusive reimbursement loophole' and suggesting regulatory action is imminent.", "pageRefs": null, "priority": null, "whenToUse": "In activist decks where the personality matters", "confidence": 0.9, "extraction": { "at": "2026-07-16 23:10:31.739183+00", "model": "or:meta-llama/llama-4-scout", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 114, "whyItWorks": "Makes the antagonist concrete", "antipattern": null, "cardinality": null, "narrativePurpose": null }, { "tool": { "name": "CEO quote contradiction", "slug": "ceo-quote-contradiction", "status": "active", "bestFor": "When management credibility is the lever", "canonId": "019dd9e1-52e9-717f-8454-93e627563ed6", "version": 1, "bodyDocId": "019dd9a1-8296-720d-8f51-da76937f9415", "description": "You reproduce management's own words — verbatim, with source and date — and\nthen place them next to the outcome that contradicts them. The CEO built\nthe rope; you put it around their own neck.", "familyLabel": null, "categoryName": null, "categorySlug": null }, "agent": null, "layer": "slide", "agents": null, "matchId": "ced44070-92d0-4b7c-a0de-6231397fee40", "evidence": "The OPO executive's statement highlights the exploitation of 'Reasonable Cost' by TransMedics, contrasting with traditional kidney pumps.", "pageRefs": null, "priority": null, "whenToUse": "When management credibility is the lever", "confidence": 0.8, "extraction": { "at": "2026-07-16 23:10:31.838302+00", "model": "or:meta-llama/llama-4-scout", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 115, "whyItWorks": "- **Maximum credibility**: no adjective you could write is as damning as the\n target's own prior statement.\n- **No rebuttal path**: management can't argue they didn't say it.\n- **It forces accountability onto a person**, not an institution — even if\n you aren't explicitly naming a villain elsewhere.\n- **Reporters amplify it**. A CEO-quote-contradiction slide is quotable,\n which means it lands in WSJ/FT/Bloomberg coverage.", "antipattern": null, "cardinality": null, "narrativePurpose": null }, { "tool": { "name": "Cliffhanger", "slug": "cliffhanger", "status": "active", "bestFor": null, "canonId": "019dd956-a34c-72a7-8c35-2ae14a425acb", "version": 1, "bodyDocId": null, "description": "Ending a section at moment of suspense to maintain engagement", "familyLabel": null, "categoryName": "Loop", "categorySlug": "loop" }, "agent": "Storyteller", "layer": "slide", "agents": [ "Storyteller" ], "matchId": "079f794e-93c5-4204-ae80-7d53ce4eb896", "evidence": "The slide mentions a 'regulatory tsunami' and the breaking up of the OPTN contract, creating a sense of impending change.", "pageRefs": null, "priority": null, "whenToUse": null, "confidence": 0.7, "extraction": { "at": "2026-07-16 23:10:31.905465+00", "model": "or:meta-llama/llama-4-scout", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 116, "whyItWorks": null, "antipattern": null, "cardinality": null, "narrativePurpose": null }, { "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null, "categoryName": null, "categorySlug": null }, "agent": null, "layer": "slide", "agents": null, "matchId": "2ec0256c-6995-4832-8156-365997bc8e5b", "evidence": "The reference to the National Organ Transplant Act of 1984 (NOTA) provides a legal basis for the accusations.", "pageRefs": null, "priority": null, "whenToUse": null, "confidence": 0.8, "extraction": { "at": "2026-07-16 23:10:32.233402+00", "model": "or:meta-llama/llama-4-scout", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 125, "whyItWorks": null, "antipattern": null, "cardinality": "common", "narrativePurpose": null }, { "tool": { "name": "Anadiplosis", "slug": "anadiplosis", "status": "active", "bestFor": null, "canonId": "019dd956-a0a5-75f9-a98c-7b7d8ee377a1", "version": 1, "bodyDocId": null, "description": "Ending one clause with a word that begins the next", "familyLabel": null, "categoryName": "Loop", "categorySlug": "loop" }, "agent": "Storyteller", "layer": "slide", "agents": [ "Storyteller" ], "matchId": "53148255-b8f4-4fd8-b6f3-d437baa25fab", "evidence": "The text repeats similar phrases, such as 'TransMedics is trying to take over the case; TransMedics is trying to take over the organ allocation; TransMedics is just pushing'.", "pageRefs": null, "priority": null, "whenToUse": null, "confidence": 0.7, "extraction": { "at": "2026-07-16 23:10:34.450166+00", "model": "or:meta-llama/llama-4-scout", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 138, "whyItWorks": null, "antipattern": null, "cardinality": null, "narrativePurpose": null }, { "tool": { "name": "Villain naming", "slug": "villain-naming", "status": "active", "bestFor": "When governance or specific decisions are the core thesis", "canonId": "019dd9e1-55a4-74db-9314-0ced4cd46cd2", "version": 1, "bodyDocId": "019dd9a1-88f1-72ad-8f4e-56ec29d7b369", "description": "You identify a **specific person** responsible for the target's underperformance\nor the behaviour you want changed — and name them. Not \"management\" or \"the\nboard\". A named executive or director with a specific failure attributable to\nthem.", "familyLabel": null, "categoryName": null, "categorySlug": null }, "agent": null, "layer": "slide", "agents": null, "matchId": "99cfba8c-6406-4867-93cb-189e9b14b6ec", "evidence": "The slide describes TransMedics as hijacking the UNOS organ allocation process and national transplant waiting list.", "pageRefs": null, "priority": null, "whenToUse": "When governance or specific decisions are the core thesis", "confidence": 0.9, "extraction": { "at": "2026-07-16 23:10:34.408485+00", "model": "or:meta-llama/llama-4-scout", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 138, "whyItWorks": "- **Accountability needs a face.** Voters (shareholders, regulators,\n journalists) act faster against people than institutions.\n- **Credibility rises with specificity.** \"The CFO has repeatedly missed\n guidance\" > \"Management has missed guidance\".\n- It **pre-empts evasion**. An individual can be removed; an abstraction\n cannot.\n- It **forces the target to respond personally** — and their defensive\n response usually generates more attention for your thesis.", "antipattern": null, "cardinality": null, "narrativePurpose": null }, { "tool": { "name": "Call-and-Response", "slug": "call-and-response", "status": "active", "bestFor": null, "canonId": "019dd956-a254-7484-a9b7-721eb21444a5", "version": 1, "bodyDocId": null, "description": "Engaging audience by creating pattern they complete mentally", "familyLabel": null, "categoryName": "Loop", "categorySlug": "loop" }, "agent": "Storyteller", "layer": "slide", "agents": [ "Storyteller" ], "matchId": "8a7a42c1-de4a-4d75-9dcc-3bf2f2d719bb", "evidence": "The slide includes a Q&A format, with questions and answers that provide evidence for the allegations.", "pageRefs": null, "priority": null, "whenToUse": null, "confidence": 0.7, "extraction": { "at": "2026-07-16 23:10:34.534975+00", "model": "or:meta-llama/llama-4-scout", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 139, "whyItWorks": null, "antipattern": null, "cardinality": null, "narrativePurpose": null }, { "tool": { "name": "Emotional Appeal", "slug": "emotional-appeal", "status": "active", "bestFor": null, "canonId": "019dd956-bde9-7668-8be7-0097678fec59", "version": 1, "bodyDocId": null, "description": "Connecting to audience feelings rather than just logic", "familyLabel": null, "categoryName": "Slide", "categorySlug": "slide" }, "agent": "Storyteller", "layer": "slide", "agents": [ "Storyteller" ], "matchId": "c2e8d1fe-4e54-4e1e-a7f2-8573fe65dbe3", "evidence": "The quote 'It’s deceptive, it’s wrong, and frankly, we are concerned that it could have caused harm to patients' evokes emotions.", "pageRefs": null, "priority": null, "whenToUse": null, "confidence": 0.5, "extraction": { "at": "2026-07-16 23:10:34.615945+00", "model": "or:meta-llama/llama-4-scout", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 140, "whyItWorks": null, "antipattern": null, "cardinality": null, "narrativePurpose": null }, { "tool": { "name": "Logical chain", "slug": "logical-chain", "status": "active", "bestFor": null, "canonId": "019dd9e1-5104-702f-8953-85757af6553d", "version": 1, "bodyDocId": null, "description": "If-then, premise-conclusion, deductive chain.", "familyLabel": null, "categoryName": null, "categorySlug": null }, "agent": null, "layer": "slide", "agents": null, "matchId": "50f31848-5f68-4067-acdd-57fbfa394989", "evidence": "The text outlines a logical sequence of events, showing how TransMedics allegedly bypasses the OPO.", "pageRefs": null, "priority": null, "whenToUse": null, "confidence": 0.7, "extraction": { "at": "2026-07-16 23:10:34.695654+00", "model": "or:meta-llama/llama-4-scout", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 141, "whyItWorks": null, "antipattern": null, "cardinality": "common", "narrativePurpose": null }, { "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null, "categoryName": null, "categorySlug": null }, "agent": null, "layer": "slide", "agents": null, "matchId": "d76c5b27-1656-4faa-9bf9-abe93dd571b2", "evidence": "The source note cites 'Scorpion Capital consultation calls with experts' as the authority for the allegations.", "pageRefs": null, "priority": null, "whenToUse": null, "confidence": 0.7, "extraction": { "at": "2026-07-16 23:10:34.776321+00", "model": "or:meta-llama/llama-4-scout", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 142, "whyItWorks": null, "antipattern": null, "cardinality": "common", "narrativePurpose": null }, { "tool": { "name": "Narrative foundations (from the Storymakers methodology)", "slug": "narrative-foundations", "status": "active", "bestFor": null, "canonId": "019df269-258b-71bd-ad14-53598df04d2b", "version": 1, "bodyDocId": "019df269-2567-736e-8b9c-4ec77611334a", "description": "This skill focuses on the *adversarial* genre — activist campaigns, short", "familyLabel": "narrative-block", "categoryName": "Narrative & Transformation", "categorySlug": "narrative-transformation" }, "agent": "storyteller", "layer": "slide", "agents": [ "storyteller" ], "matchId": "ca49df01-3469-4cab-aed8-5bc1186e9c2a", "evidence": "The text provides a narrative of events, setting a foundation for the allegations.", "pageRefs": null, "priority": null, "whenToUse": null, "confidence": 0.5, "extraction": { "at": "2026-07-16 23:10:34.911779+00", "model": "or:meta-llama/llama-4-scout", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 144, "whyItWorks": null, "antipattern": null, "cardinality": null, "narrativePurpose": null }, { "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null, "categoryName": null, "categorySlug": null }, "agent": null, "layer": "slide", "agents": null, "matchId": "f3af15c0-db10-4d13-8ac5-0de3d6d386d1", "evidence": "The quote is attributed to a 'Veteran transplant administrator/executive at Massachusetts General Hospital'.", "pageRefs": null, "priority": null, "whenToUse": null, "confidence": 0.7, "extraction": { "at": "2026-07-16 23:10:35.040841+00", "model": "or:meta-llama/llama-4-scout", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 146, "whyItWorks": null, "antipattern": null, "cardinality": "common", "narrativePurpose": null }, { "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null, "categoryName": null, "categorySlug": null }, "agent": null, "layer": "slide", "agents": null, "matchId": "7e5f944e-e998-4660-b5c7-d132b1fa001c", "evidence": "The allegations are attributed to multiple sources, including a transplant administrator.", "pageRefs": null, "priority": null, "whenToUse": null, "confidence": 0.7, "extraction": { "at": "2026-07-16 23:10:35.161051+00", "model": "or:meta-llama/llama-4-scout", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 148, "whyItWorks": null, "antipattern": null, "cardinality": "common", "narrativePurpose": null }, { "tool": { "name": "Slide visual craft", "slug": "visual-craft", "status": "active", "bestFor": null, "canonId": "019df269-2d56-7739-ab65-cc2e091a109b", "version": 1, "bodyDocId": "019df269-2d32-736a-ae59-0250c5540c9a", "description": "What separates a 5/5-visual-craft deck from a 3/5 one.", "familyLabel": "slide-recipe", "categoryName": "Slide", "categorySlug": "slide" }, "agent": "designer", "layer": "slide", "agents": [ "designer" ], "matchId": "ef0e0155-84df-4485-a7d0-8e8bebc47532", "evidence": "The slide includes an image of the UNOS website interface showing DonorNet functionality and login screen.", "pageRefs": null, "priority": null, "whenToUse": null, "confidence": 0.7, "extraction": { "at": "2026-07-16 23:10:35.242709+00", "model": "or:meta-llama/llama-4-scout", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 149, "whyItWorks": null, "antipattern": null, "cardinality": null, "narrativePurpose": null }, { "tool": { "name": "Anadiplosis", "slug": "anadiplosis", "status": "active", "bestFor": null, "canonId": "019dd956-a0a5-75f9-a98c-7b7d8ee377a1", "version": 1, "bodyDocId": null, "description": "Ending one clause with a word that begins the next", "familyLabel": null, "categoryName": "Loop", "categorySlug": "loop" }, "agent": "Storyteller", "layer": "slide", "agents": [ "Storyteller" ], "matchId": "4ca43971-81a1-4011-b92f-db3ed132bb85", "evidence": "The Massachusetts General executive stated that they would never hire a surgeon who ever worked there; and noted that TransMedics quickly hired a surgeon they fired due to 'quality issues' - This is an example of anadiplosis, where a point is emphasized by repeating it in a different way.", "pageRefs": null, "priority": null, "whenToUse": null, "confidence": 0.7, "extraction": { "at": "2026-07-16 23:10:38.432383+00", "model": "or:meta-llama/llama-4-scout", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 198, "whyItWorks": null, "antipattern": null, "cardinality": null, "narrativePurpose": null }, { "tool": { "name": "Villain slide", "slug": "villain-slide", "status": "active", "bestFor": "In activist decks where the personality matters", "canonId": "019dd9e1-518c-7404-976a-5be5a517b659", "version": 1, "bodyDocId": null, "description": "A dedicated slide presenting the named villain visually", "familyLabel": null, "categoryName": null, "categorySlug": null }, "agent": null, "layer": "slide", "agents": null, "matchId": "1bb5e0d9-3f0d-48ba-bdc6-edc6ecd83c0d", "evidence": "The slide presents a critical view of TransMedics, highlighting a surgeon's resignation due to forced engagement in inappropriate and unsafe conduct.", "pageRefs": null, "priority": null, "whenToUse": "In activist decks where the personality matters", "confidence": 0.9, "extraction": { "at": "2026-07-16 23:10:37.243307+00", "model": "or:meta-llama/llama-4-scout", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 210, "whyItWorks": "Makes the antagonist concrete", "antipattern": null, "cardinality": null, "narrativePurpose": null }, { "tool": { "name": "Anadiplosis", "slug": "anadiplosis", "status": "active", "bestFor": null, "canonId": "019dd956-a0a5-75f9-a98c-7b7d8ee377a1", "version": 1, "bodyDocId": null, "description": "Ending one clause with a word that begins the next", "familyLabel": null, "categoryName": "Loop", "categorySlug": "loop" }, "agent": "Storyteller", "layer": "slide", "agents": [ "Storyteller" ], "matchId": "1c5ea8ed-308f-41e1-82f4-941740faf37b", "evidence": "The use of repeated phrases and testimonials from experts creates an anadiplosis effect, emphasizing the severity of the issue.", "pageRefs": null, "priority": null, "whenToUse": null, "confidence": 0.7, "extraction": { "at": "2026-07-17 03:28:52.230168+00", "model": "or:meta-llama/llama-4-scout", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 239, "whyItWorks": null, "antipattern": null, "cardinality": null, "narrativePurpose": null }, { "tool": { "name": "Villain slide", "slug": "villain-slide", "status": "active", "bestFor": "In activist decks where the personality matters", "canonId": "019dd9e1-518c-7404-976a-5be5a517b659", "version": 1, "bodyDocId": null, "description": "A dedicated slide presenting the named villain visually", "familyLabel": null, "categoryName": null, "categorySlug": null }, "agent": null, "layer": "slide", "agents": null, "matchId": "b36e7e3f-89dd-49ef-9847-a679f2011c0e", "evidence": "The slide presents a critical view of TransMedics, highlighting the incompetence of OCS Specialists and the risks they pose to organ procurement and transplantation.", "pageRefs": null, "priority": null, "whenToUse": "In activist decks where the personality matters", "confidence": 0.9, "extraction": { "at": "2026-07-17 03:28:52.191272+00", "model": "or:meta-llama/llama-4-scout", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 239, "whyItWorks": "Makes the antagonist concrete", "antipattern": null, "cardinality": null, "narrativePurpose": null }, { "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null, "categoryName": null, "categorySlug": null }, "agent": null, "layer": "slide", "agents": null, "matchId": "20b4015e-f704-432d-bbaf-1d9d72830cbc", "evidence": "The inclusion of a quote from Congressman Paul Gosar adds credibility to the critique.", "pageRefs": null, "priority": null, "whenToUse": null, "confidence": 0.7, "extraction": { "at": "2026-07-17 03:28:52.349836+00", "model": "or:meta-llama/llama-4-scout", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 241, "whyItWorks": null, "antipattern": null, "cardinality": "common", "narrativePurpose": null }, { "tool": { "name": "Call to action", "slug": "call-to-action", "status": "active", "bestFor": null, "canonId": "019dd9e1-4bbb-702a-9ead-82daf188bb7c", "version": 1, "bodyDocId": null, "description": "Explicit prescription of what the audience should do next.", "familyLabel": null, "categoryName": null, "categorySlug": null }, "agent": null, "layer": "slide", "agents": null, "matchId": "31d768a7-c092-46e9-a8ac-95ae5c1e2c3e", "evidence": "The slide implies a call to action, emphasizing the need for change.", "pageRefs": null, "priority": null, "whenToUse": null, "confidence": 0.7, "extraction": { "at": "2026-07-17 03:28:52.506659+00", "model": "or:meta-llama/llama-4-scout", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 244, "whyItWorks": null, "antipattern": null, "cardinality": "common", "narrativePurpose": null }, { "tool": { "name": "Anadiplosis", "slug": "anadiplosis", "status": "active", "bestFor": null, "canonId": "019dd956-a0a5-75f9-a98c-7b7d8ee377a1", "version": 1, "bodyDocId": null, "description": "Ending one clause with a word that begins the next", "familyLabel": null, "categoryName": "Loop", "categorySlug": "loop" }, "agent": "Storyteller", "layer": "slide", "agents": [ "Storyteller" ], "matchId": "2e843d80-f267-44c6-bb0b-ebca8402693e", "evidence": "A second OCS Specialist provided similar color, and elaborated on their improper use as surgical assistants despite no such training or credentials, as well as their engaging in the practice of medicine", "pageRefs": null, "priority": null, "whenToUse": null, "confidence": 0.7, "extraction": { "at": "2026-07-16 23:10:40.440202+00", "model": "or:meta-llama/llama-4-scout", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 247, "whyItWorks": null, "antipattern": null, "cardinality": null, "narrativePurpose": null }, { "tool": { "name": "Call-and-Response", "slug": "call-and-response", "status": "active", "bestFor": null, "canonId": "019dd956-a254-7484-a9b7-721eb21444a5", "version": 1, "bodyDocId": null, "description": "Engaging audience by creating pattern they complete mentally", "familyLabel": null, "categoryName": "Loop", "categorySlug": "loop" }, "agent": "Storyteller", "layer": "slide", "agents": [ "Storyteller" ], "matchId": "773e09ed-114f-4860-ac1e-a40cb0dab8e9", "evidence": "quote/testimonial: You are by yourself. It’s like an OCS specialist and then a surgeon, and it is stressful because they’re wanting you to call out times...you also have to put in the cardioplegia...you have to put on th", "pageRefs": null, "priority": null, "whenToUse": null, "confidence": 0.7, "extraction": { "at": "2026-07-16 23:10:40.474109+00", "model": "or:meta-llama/llama-4-scout", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 247, "whyItWorks": null, "antipattern": null, "cardinality": null, "narrativePurpose": null }, { "tool": { "name": "Action Titles", "slug": "action-titles", "status": "active", "bestFor": "Any decision-grade deliverable — strategy recommendation, board update, investment memo, M&A review, post-mortem — where the reader is being asked to agree, decide, or act and will skim the title bar at speed.", "canonId": "019dd956-ac70-700b-a608-ba58e78f5dcc", "version": 1, "bodyDocId": "816dad3c-9983-41c1-a86e-978ebd582841", "description": "The McKinsey-bred discipline of writing every slide title as a complete declarative sentence with a verb and an insight, not a topic label. Each title is a sub-claim that ladders up to the deck's governing thought; read in sequence, the titles reconstruct the executive summary.", "familyLabel": null, "categoryName": "Slide", "categorySlug": "slide" }, "agent": "Architect", "layer": "slide", "agents": [ "Architect" ], "matchId": "7ba82a1c-d789-4e92-9c08-acb9f74f0a31", "evidence": "The slide has an action title 'A surgeon who directs the program expects to terminate their usage in the next 6-12 months: “Yes, it will go to zero.”'", "pageRefs": null, "priority": "Core", "whenToUse": "Any decision-grade deliverable — strategy recommendation, board update, investment memo, M&A review, post-mortem — where the reader is being asked to agree, decide, or act and will skim the title bar at speed.", "confidence": 0.7, "extraction": { "at": "2026-07-16 23:10:53.310228+00", "model": "or:meta-llama/llama-4-scout", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 276, "whyItWorks": "Solves two failure modes at once. (1) The buried claim: action titles place the conclusion on the page before any analysis is read, so a busy reader doesn't reverse-engineer it from the chart. (2) The spineless deck: because each title is a claim, slides have to ladder up to the governing thought; logical gaps become visible as topic-shaped titles in a sequence that no longer reads as a story.", "antipattern": "Topic labels disguised as titles — Volume by quarter, Key findings, Pricing strategy, Margins have been impacted. No verb, or a passive verb with no agent, or a fact (Revenue grew 12%) without the so-what. Also: titles that overreach the chart's evidence, multi-claim X-grew-but-Y-fell welded titles, and mechanical repetition of the same X-drove-Y template across the deck.", "cardinality": null, "narrativePurpose": "Forces the deck to carry its argument in the title bar so a senior reader can extract the recommendation without opening a single slide; converts a binder of topics into a navigable pyramid where every slide is a node defending the apex." }, { "tool": { "name": "Villain slide", "slug": "villain-slide", "status": "active", "bestFor": "In activist decks where the personality matters", "canonId": "019dd9e1-518c-7404-976a-5be5a517b659", "version": 1, "bodyDocId": null, "description": "A dedicated slide presenting the named villain visually", "familyLabel": null, "categoryName": null, "categorySlug": null }, "agent": null, "layer": "slide", "agents": null, "matchId": "cafca373-9102-4107-b244-e85ea7229779", "evidence": "The slide presents a critical view of TransMedics, highlighting damaging information about their practices.", "pageRefs": null, "priority": null, "whenToUse": "In activist decks where the personality matters", "confidence": 0.9, "extraction": { "at": "2026-07-16 23:10:45.025461+00", "model": "or:meta-llama/llama-4-scout", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 332, "whyItWorks": "Makes the antagonist concrete", "antipattern": null, "cardinality": null, "narrativePurpose": null } ], "frameworks": [ { "matchId": "776e7252-7147-40e8-ad3b-e4f101cfd672", "evidence": "The slide explicitly frames the company leadership as a 'villain' or 'thug' to build a case against them.", "framework": null, "confidence": 0.9, "extraction": { "at": "2026-05-02 21:25:44.822+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 3, "frameworkName": "antagonist-introduction" }, { "matchId": "d6b02247-3785-4b5a-871e-a28e766b3eb1", "evidence": "The slide uses a customer quote to directly contradict the company's stated position.", "framework": null, "confidence": 0.9, "extraction": { "at": "2026-05-02 21:25:45.139+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 6, "frameworkName": "ceo-quote-contradiction" }, { "matchId": "a9072226-f23f-44e3-ad9e-2389a7bbd0a2", "evidence": "Comparison of TransMedics to Blackberry's decline.", "framework": null, "confidence": 0.9, "extraction": { "at": "2026-05-02 21:25:48.064+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 7, "frameworkName": "argument-from-analogy" }, { "matchId": "f29923a4-99b4-4e9d-bfae-57a354b9e78d", "evidence": "The slide explicitly frames the CEO and company as a 'mafia-style' villain.", "framework": null, "confidence": 0.9, "extraction": { "at": "2026-05-02 21:25:46.492+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 11, "frameworkName": "antagonist-introduction" }, { "matchId": "15973f97-4960-4431-a5ac-bd094bdfd287", "evidence": "Framing the CEO's responses as 'denial and attack' based on 'Spy The Lie' methodology.", "framework": null, "confidence": 0.85, "extraction": { "at": "2026-05-02 21:25:47.831+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 12, "frameworkName": "antagonist-introduction" }, { "matchId": "a2014d1f-8b8e-4ee2-a8f3-6ee9ccb0758a", "evidence": "Contrasting CEO public statements with private trading behavior and citing legal precedents.", "framework": null, "confidence": 0.9, "extraction": { "at": "2026-05-02 20:12:06.591+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 14, "frameworkName": "fraud-exposure" }, { "matchId": "906b1912-3aef-4fc1-b9ce-e5d7ba9875fc", "evidence": "The slide explicitly frames the company's marketing as a 'dirty little secret' to expose a contradiction between clinical claims and actual usage drivers.", "framework": null, "confidence": 0.9, "extraction": { "at": "2026-05-02 20:12:08.706+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 16, "frameworkName": "fraud-exposure" }, { "matchId": "e22c7a23-7b36-4135-9723-1486504e986a", "evidence": "Direct quotes from customers used to validate a business thesis.", "framework": null, "confidence": 1, "extraction": { "at": "2026-05-02 20:12:10.47+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 18, "frameworkName": "testimonial" }, { "matchId": "c6a0d48f-05a7-4bb7-867e-854b2d135387", "evidence": "The slide explicitly frames the company as 'greedy' and 'predatory' to justify a short thesis.", "framework": null, "confidence": 0.9, "extraction": { "at": "2026-05-02 20:12:07.177+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 20, "frameworkName": "antagonist-introduction" }, { "matchId": "2dfee5ea-b5b1-4e66-9de4-3b1eef66c085", "evidence": "The slide frames TransMedics as the antagonist in a narrative of customer dissatisfaction and business failure.", "framework": null, "confidence": 0.8, "extraction": { "at": "2026-05-02 20:12:03.178+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 21, "frameworkName": "antagonist-introduction" }, { "matchId": "9385638e-8559-4959-b326-f91904efb43d", "evidence": "The slide frames TransMedics as a 'villain' exploiting the healthcare system.", "framework": null, "confidence": 0.9, "extraction": { "at": "2026-05-02 20:12:04.27+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 24, "frameworkName": "antagonist-introduction" }, { "matchId": "81ca706a-0a78-4c78-8899-9d9eed426925", "evidence": "The slide frames the business model as a 'government pay scam' and 'loophole' to be exposed.", "framework": null, "confidence": 0.9, "extraction": { "at": "2026-05-02 20:12:11.767+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 25, "frameworkName": "fraud-exposure" }, { "matchId": "feff230c-68b6-4e9c-9b43-652f2d15e42e", "evidence": "The slide explicitly frames TransMedics as a 'bait-and-switch' operator exploiting Medicare.", "framework": null, "confidence": 0.9, "extraction": { "at": "2026-05-02 20:12:03.697+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 27, "frameworkName": "antagonist-introduction" }, { "matchId": "6fb10e6b-ef12-43f6-ad43-22ff9e026724", "evidence": "The slide explicitly frames the company's business model as a 'Medicare rig' and 'disingenuous' to expose potential financial misconduct.", "framework": null, "confidence": 0.9, "extraction": { "at": "2026-05-02 20:12:05.563+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 28, "frameworkName": "fraud-exposure" }, { "matchId": "3ed6fbda-0191-4e03-baeb-d34307a283c6", "evidence": "The slide explicitly frames the company's business model as a 'boondoggle' and cites expert testimony regarding DOJ/OIG investigations into fraud and bribery.", "framework": null, "confidence": 0.9, "extraction": { "at": "2026-05-02 20:12:05.337+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 29, "frameworkName": "fraud-exposure" }, { "matchId": "6a050a73-0514-4d37-9595-2f5d3bb78c79", "evidence": "The slide explicitly frames the investigation as a potential fraud case involving kickbacks.", "framework": null, "confidence": 0.8, "extraction": { "at": "2026-05-02 20:12:04.671+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 32, "frameworkName": "fraud-exposure" }, { "matchId": "21d95dc8-4cf5-45fa-a78e-75cab43cdaaa", "evidence": "The slide explicitly discusses allegations of kickbacks and investigative inquiries into financial incentives.", "framework": null, "confidence": 0.9, "extraction": { "at": "2026-05-02 20:12:04.001+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 33, "frameworkName": "fraud-exposure" }, { "matchId": "08ad6e43-e091-4fde-af55-22d74fb0ee08", "evidence": "The slide explicitly links nepotism and ethnic networks to fraud indicators.", "framework": null, "confidence": 0.9, "extraction": { "at": "2026-05-02 20:12:07.094+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 34, "frameworkName": "fraud-exposure" }, { "matchId": "07227321-be6d-44a4-8611-cb9635b51b99", "evidence": "The slide explicitly links corporate figures to 'dubious conduct' and 'kickbacks' to expose potential fraud.", "framework": null, "confidence": 0.9, "extraction": { "at": "2026-05-02 20:12:05.049+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 36, "frameworkName": "fraud-exposure" }, { "matchId": "22aeb66f-3e0f-43f4-835b-1c319ba471f8", "evidence": "The slide uses guilt-by-association to undermine the credibility of the company's leadership team.", "framework": null, "confidence": 0.9, "extraction": { "at": "2026-05-02 20:12:05.207+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 38, "frameworkName": "expose_contradiction" }, { "matchId": "d0204860-09d6-4c9a-bd2b-cfd865698d04", "evidence": "The slide highlights a specific allegation of anti-competitive behavior and its impact on stock price.", "framework": null, "confidence": 0.8, "extraction": { "at": "2026-05-02 20:12:02.404+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 42, "frameworkName": "fraud-exposure" }, { "matchId": "516d7fde-b93f-4f36-8a1e-0e1e52b9cd3a", "evidence": "The slide explicitly frames corporate actions as 'hostage' taking and 'loophole' exploitation to be exposed.", "framework": null, "confidence": 0.9, "extraction": { "at": "2026-05-02 20:12:07.684+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 45, "frameworkName": "fraud-exposure" }, { "matchId": "592a5cd6-e8c4-416d-b3c8-9e8d0aef552f", "evidence": "The slide contrasts the CEO's aggressive tone with the formal letter content to highlight a defensive stance.", "framework": null, "confidence": 0.8, "extraction": { "at": "2026-05-02 20:12:07.64+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 47, "frameworkName": "ceo-quote-contradiction" }, { "matchId": "6d94febb-3a35-4292-9fbf-e79d2c2c7a64", "evidence": "The slide explicitly contrasts CEO claims with ex-employee testimony.", "framework": null, "confidence": 0.9, "extraction": { "at": "2026-05-02 20:12:08.134+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 50, "frameworkName": "ceo-quote-contradiction" }, { "matchId": "a007bc2e-2ef3-44a5-84ac-3c9de9a56cec", "evidence": "Uses expert testimony from surgeons to validate a claim about business practices.", "framework": null, "confidence": 0.9, "extraction": { "at": "2026-05-02 20:12:08.329+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 51, "frameworkName": "authority-citation" }, { "matchId": "65afdace-1dbd-4e05-a753-706c827a48d9", "evidence": "Contradicting CEO statements with expert testimony to allege coercive business practices.", "framework": null, "confidence": 0.9, "extraction": { "at": "2026-05-02 20:12:08.436+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 55, "frameworkName": "fraud-exposure" }, { "matchId": "3cb9b7f8-f088-439a-b2fd-5d17717eb785", "evidence": "The slide explicitly contrasts a CEO's official statement with expert testimony to allege a falsehood.", "framework": null, "confidence": 0.9, "extraction": { "at": "2026-05-02 21:25:47.602+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 56, "frameworkName": "fraud-exposure" }, { "matchId": "c68cc4a0-e146-4263-b9d6-2db9e2009afb", "evidence": "The slide explicitly contrasts an external allegation with a direct rebuttal from the CEO.", "framework": null, "confidence": 0.9, "extraction": { "at": "2026-05-02 20:12:10.562+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 57, "frameworkName": "expose_contradiction" }, { "matchId": "91eeea26-150a-4a1d-88dc-602412d809d8", "evidence": "The slide explicitly frames the content as an allegation of price gouging and 'outrageous practice' to expose potential corporate misconduct.", "framework": null, "confidence": 0.9, "extraction": { "at": "2026-05-02 20:12:08.528+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 59, "frameworkName": "fraud-exposure" }, { "matchId": "38b21427-c50c-4183-9777-6a4426901aed", "evidence": "The slide frames TransMedics as a predatory entity through expert testimonials.", "framework": null, "confidence": 0.9, "extraction": { "at": "2026-05-02 20:12:10.426+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 60, "frameworkName": "antagonist-introduction" }, { "matchId": "086322a1-96a6-4ece-ae59-89298940fe36", "evidence": "Uses quotes from 'top liver transplant surgeons' and 'KOLs' to validate the argument.", "framework": null, "confidence": 0.9, "extraction": { "at": "2026-05-02 20:12:09.219+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 61, "frameworkName": "authority-citation" }, { "matchId": "12b89533-9b10-46e7-935d-64d9fb61e5d7", "evidence": "The slide explicitly frames the company's business practices as coercive and manipulative, aiming to expose unethical behavior.", "framework": null, "confidence": 0.85, "extraction": { "at": "2026-05-02 20:12:11.553+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 67, "frameworkName": "fraud-exposure" }, { "matchId": "cb8c2966-4193-4657-81f7-7ea26266c1c7", "evidence": "The slide explicitly frames the subject company as a 'villain' using quotes like 'mafia-style' and 'racketeering'.", "framework": null, "confidence": 0.9, "extraction": { "at": "2026-05-02 20:12:10.437+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 69, "frameworkName": "antagonist-introduction" }, { "matchId": "ff5a9c84-ec49-4475-81fe-91d48abb580e", "evidence": "The slide explicitly labels the company's program as a 'fraudulent billing conspiracy' and uses the map to illustrate the scope of the alleged scheme.", "framework": null, "confidence": 0.95, "extraction": { "at": "2026-05-02 21:25:52.554+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 71, "frameworkName": "fraud-exposure" }, { "matchId": "c556ef33-6dc6-40fe-be86-f9f3b331409a", "evidence": "The slide explicitly details mechanisms of systematic billing fraud.", "framework": null, "confidence": 1, "extraction": { "at": "2026-05-02 20:12:11.064+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 72, "frameworkName": "fraud-exposure" }, { "matchId": "1a6fb0d7-8156-4b89-a3fe-ac950bc1611f", "evidence": "The slide presents testimony alleging unethical overbilling practices.", "framework": null, "confidence": 0.9, "extraction": { "at": "2026-05-02 20:12:14.021+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 73, "frameworkName": "fraud-exposure" }, { "matchId": "f1db08c5-527f-4744-8a6b-8ab7feb4a92c", "evidence": "The slide explicitly frames the testimony as evidence of fraudulent air billing.", "framework": null, "confidence": 0.9, "extraction": { "at": "2026-05-02 20:12:12.131+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 74, "frameworkName": "fraud-exposure" }, { "matchId": "ea0d28eb-092e-4fa8-a4e6-0de708e434f7", "evidence": "The slide uses expert testimony to expose operational inefficiencies and questionable business practices.", "framework": null, "confidence": 0.9, "extraction": { "at": "2026-05-02 20:12:12.693+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 79, "frameworkName": "fraud-exposure" }, { "matchId": "05cf8afd-a6c6-4400-bb27-7e5616e327b5", "evidence": "The slide explicitly documents an alleged scheme of billing for unnecessary services (flights) to inflate costs.", "framework": null, "confidence": 0.95, "extraction": { "at": "2026-05-02 20:12:14.631+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 83, "frameworkName": "fraud-exposure" }, { "matchId": "2a2ce627-aaa8-47ee-bedc-cb237ad559ae", "evidence": "The slide explicitly frames the content as exposing a scheme and questioning the truthfulness of billing practices.", "framework": null, "confidence": 0.9, "extraction": { "at": "2026-05-02 20:12:13.618+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 84, "frameworkName": "fraud-exposure" }, { "matchId": "d91cb24e-a13b-46f5-9318-4b11faa5949a", "evidence": "The slide explicitly frames the conduct as 'fraud' and 'extortion' based on expert testimony.", "framework": null, "confidence": 0.9, "extraction": { "at": "2026-05-02 20:12:14.686+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 85, "frameworkName": "fraud-exposure" }, { "matchId": "86496d74-8e7a-465f-8c7b-236acec696e0", "evidence": "The slide explicitly aims to expose a contradiction between corporate claims and operational reality.", "framework": null, "confidence": 0.9, "extraction": { "at": "2026-05-02 20:12:15.588+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 86, "frameworkName": "fraud-exposure" }, { "matchId": "fec478d3-6d60-4746-ba8c-d5469b75a23e", "evidence": "The slide explicitly documents an allegation of fraudulent billing and extortion.", "framework": null, "confidence": 0.9, "extraction": { "at": "2026-05-02 20:12:18.891+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 89, "frameworkName": "fraud-exposure" }, { "matchId": "7879ed16-87cb-4273-acae-d44509052516", "evidence": "The slide explicitly frames the company's actions as 'racketeering-type tactics' and 'mafia-style' to expose potential misconduct.", "framework": null, "confidence": 0.9, "extraction": { "at": "2026-05-02 20:12:14.733+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 94, "frameworkName": "fraud-exposure" }, { "matchId": "b4b31a1a-ddf0-4252-a181-db9b56c36df5", "evidence": "The slide explicitly frames the business practice as 'billing fraud' and uses expert testimony to contrast high costs with low-cost alternatives.", "framework": null, "confidence": 0.9, "extraction": { "at": "2026-05-02 20:12:15.153+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 95, "frameworkName": "fraud-exposure" }, { "matchId": "233500d0-e205-4aba-bdbd-4044a7f8c098", "evidence": "The slide explicitly frames the company's billing practices as a 'scheme' and uses expert testimony to contradict the stated value proposition.", "framework": null, "confidence": 0.9, "extraction": { "at": "2026-05-02 20:12:15.234+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 96, "frameworkName": "fraud-exposure" }, { "matchId": "05c606e2-62da-45d8-8bec-7992a36af345", "evidence": "The slide explicitly frames the company's business model as a 'medtech or biotech fraud' and uses investigative techniques to expose alleged conflicts of interest.", "framework": null, "confidence": 0.9, "extraction": { "at": "2026-05-02 20:12:19.316+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 99, "frameworkName": "fraud-exposure" }, { "matchId": "21998245-6a89-420a-85e7-9b98fc496b1b", "evidence": "Uses expert surgeon quotes to validate revenue concentration claims.", "framework": null, "confidence": 0.9, "extraction": { "at": "2026-05-02 20:12:16.548+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 103, "frameworkName": "authority-citation" }, { "matchId": "ca1b86e6-7aae-4442-a125-42d6c9d66d6f", "evidence": "The slide explicitly frames the content as exposing potential kickbacks and conflicts of interest.", "framework": null, "confidence": 0.9, "extraction": { "at": "2026-05-02 20:12:17.361+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 106, "frameworkName": "fraud-exposure" }, { "matchId": "4e7dce55-c0d6-430c-bdfb-c169fa92c1dc", "evidence": "The slide explicitly frames the content as exposing a scheme or unethical practice.", "framework": null, "confidence": 0.9, "extraction": { "at": "2026-05-02 20:12:16.987+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 107, "frameworkName": "fraud-exposure" }, { "matchId": "e456e489-0f3b-4cec-b846-b30f48e49094", "evidence": "The slide explicitly discusses allegations of kickbacks and investigations by the Washington Post and federal/state investigators.", "framework": null, "confidence": 0.9, "extraction": { "at": "2026-05-02 20:12:18.216+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 111, "frameworkName": "fraud-exposure" }, { "matchId": "282574ec-cbf7-4fad-ab4c-ecd1ca3d5abc", "evidence": "The slide highlights a specific loophole in cost reporting being abused by industry players.", "framework": null, "confidence": 0.9, "extraction": { "at": "2026-05-02 20:12:18.006+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 113, "frameworkName": "fraud-exposure" }, { "matchId": "cd77a495-ac4f-496e-aa8b-bcbb401920aa", "evidence": "Uses an industry expert quote to undermine the company's business model.", "framework": null, "confidence": 0.9, "extraction": { "at": "2026-05-02 20:12:17.723+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 115, "frameworkName": "ceo-quote-contradiction" }, { "matchId": "27bb7443-7283-409d-9e76-a539f3717ae3", "evidence": "Citing a CEO of a major OPO to validate regulatory risk", "framework": null, "confidence": 0.9, "extraction": { "at": "2026-05-02 20:12:18.055+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 116, "frameworkName": "authority-citation" }, { "matchId": "5df818e2-da4b-4525-bc77-2d5b6f6ccb0f", "evidence": "The slide explicitly frames the company's actions as a cover-up of regulatory reporting requirements.", "framework": null, "confidence": 0.9, "extraction": { "at": "2026-05-02 20:12:17.443+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 117, "frameworkName": "fraud-exposure" }, { "matchId": "ed619cdc-0cad-450c-923c-75949a1324df", "evidence": "The slide explicitly identifies 'anomalies' and 'suggestive of kickbacks' in financial data.", "framework": null, "confidence": 0.9, "extraction": { "at": "2026-05-02 20:12:18.985+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 118, "frameworkName": "fraud-exposure" }, { "matchId": "de5b61bb-151a-4a37-83aa-6d1ad34823fb", "evidence": "The slide explicitly contrasts company behavior with regulatory reporting requirements to imply wrongdoing.", "framework": null, "confidence": 0.9, "extraction": { "at": "2026-05-02 20:12:18.475+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 119, "frameworkName": "fraud-exposure" }, { "matchId": "705d5dfe-342b-4755-854a-489f41e7bff4", "evidence": "The slide presents allegations of corruption and investigation to contrast with the public perception of the industry.", "framework": null, "confidence": 0.8, "extraction": { "at": "2026-05-02 20:12:18.847+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 122, "frameworkName": "expose_contradiction" }, { "matchId": "21891a65-e559-4297-a82b-17618005689a", "evidence": "The slide presents a competitor's testimony to undermine the value proposition of the subject company.", "framework": null, "confidence": 0.9, "extraction": { "at": "2026-05-02 20:12:21.444+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 131, "frameworkName": "expose_contradiction" }, { "matchId": "b83022aa-72cb-49fc-bea4-bc42929c28a9", "evidence": "Framing the medical system as a 'cartel' and users as 'addicted to volume'", "framework": null, "confidence": 0.8, "extraction": { "at": "2026-05-02 20:12:20.887+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 132, "frameworkName": "antagonist-introduction" }, { "matchId": "8e7fa5d3-781c-4c5a-b045-86a4a7cf3b0c", "evidence": "The slide explicitly details a mechanism for bypassing regulatory systems (UNOS) for financial gain.", "framework": null, "confidence": 0.9, "extraction": { "at": "2026-05-02 20:12:25.531+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 133, "frameworkName": "fraud-exposure" }, { "matchId": "aaa48f80-fd90-4a1b-bbed-fbc635915aee", "evidence": "The slide explicitly frames the described business practices as 'nefarious' and 'risking FBI raids'.", "framework": null, "confidence": 0.9, "extraction": { "at": "2026-05-02 20:12:27.166+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 134, "frameworkName": "fraud-exposure" }, { "matchId": "d03a0d77-37f9-48f0-b2c5-4d7e6de78c0e", "evidence": "The slide explicitly frames the described business arrangement as 'the very definition of a kickback'.", "framework": null, "confidence": 0.9, "extraction": { "at": "2026-05-02 20:12:25.399+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 135, "frameworkName": "fraud-exposure" }, { "matchId": "d722c5d6-9cd7-43ca-aa88-67dbe4e6c937", "evidence": "The slide explicitly frames the business relationship as 'Kickbacks' and 'allegedly not paying for the devices'.", "framework": null, "confidence": 0.9, "extraction": { "at": "2026-05-02 20:12:21.599+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 136, "frameworkName": "fraud-exposure" }, { "matchId": "9aff58b2-f2cc-4db4-8304-9b304fb157d3", "evidence": "The slide frames TransMedics as a villainous actor through expert testimony.", "framework": null, "confidence": 0.9, "extraction": { "at": "2026-05-02 20:12:22.933+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 137, "frameworkName": "antagonist-introduction" }, { "matchId": "905fc085-31ce-4cdb-be6c-076a683b15c1", "evidence": "The slide frames TransMedics as a bad actor violating federal law.", "framework": null, "confidence": 0.8, "extraction": { "at": "2026-05-02 20:12:22.322+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 139, "frameworkName": "antagonist-introduction" }, { "matchId": "aec7fbdb-4dcc-4ab1-a391-e8e6380f9986", "evidence": "The slide explicitly frames the testimonial as a 'smoking gun' to expose alleged unethical business practices.", "framework": null, "confidence": 0.9, "extraction": { "at": "2026-05-02 20:12:22.809+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 143, "frameworkName": "fraud-exposure" }, { "matchId": "476fb26b-78e8-4d1a-973a-577f127086f3", "evidence": "The slide frames TransMedics as a villainous entity manipulating organ allocation for profit.", "framework": null, "confidence": 0.8, "extraction": { "at": "2026-05-02 20:12:22.68+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 145, "frameworkName": "antagonist-introduction" }, { "matchId": "d7725ef3-8a1c-41e7-a1ab-df814fbc8957", "evidence": "The slide explicitly details an alleged scheme to bypass regulatory (OPTN) guidelines for commercial gain.", "framework": null, "confidence": 0.9, "extraction": { "at": "2026-05-02 20:12:24.014+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 147, "frameworkName": "fraud-exposure" }, { "matchId": "5aeb820b-1e3c-4c18-b0fc-4ca1b5275509", "evidence": "The slide explicitly frames the narrative around a potential violation of data use agreements and unauthorized access to sensitive patient data.", "framework": null, "confidence": 0.9, "extraction": { "at": "2026-05-02 20:12:23.852+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 152, "frameworkName": "fraud-exposure" }, { "matchId": "2d800cb0-186e-4e96-86b8-1d15ef3f0a25", "evidence": "The slide frames the company as a 'racket' and identifies an existential risk, positioning them as the villain in the research narrative.", "framework": null, "confidence": 0.9, "extraction": { "at": "2026-05-02 20:12:23.044+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 154, "frameworkName": "antagonist-introduction" }, { "matchId": "b9211217-296c-4c4a-a821-4d32e6d52dd3", "evidence": "The slide explicitly claims a 'racket' and 'defrauded' payors, contrasting this with official FDA documentation.", "framework": null, "confidence": 0.95, "extraction": { "at": "2026-05-02 20:12:24.83+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 155, "frameworkName": "fraud-exposure" }, { "matchId": "619f2ecc-af26-457d-a1fa-a162f5278288", "evidence": "Contrasts investor day 'Game Changer' claim with ex-employee testimonial about scheduling convenience.", "framework": null, "confidence": 0.9, "extraction": { "at": "2026-05-02 20:12:24.463+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 157, "frameworkName": "ceo-quote-contradiction" }, { "matchId": "3a701efa-83ff-48eb-8979-5021aa9a235b", "evidence": "The slide uses expert testimony to contradict the company's business model claims.", "framework": null, "confidence": 0.9, "extraction": { "at": "2026-05-02 20:12:46.732+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 159, "frameworkName": "fraud-exposure" }, { "matchId": "7e5d7336-00e8-4acc-82b6-6878c5f507b8", "evidence": "The slide explicitly exposes a gap between the stated clinical value and the actual usage for convenience, framing it as a deceptive practice.", "framework": null, "confidence": 0.9, "extraction": { "at": "2026-05-02 20:12:32.442+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 163, "frameworkName": "fraud-exposure" }, { "matchId": "51fb5bfb-b05a-436a-8037-b59360cc2e9e", "evidence": "The slide explicitly frames the behavior as 'fabricating a clinical indication' and 'unsustainable' cost-shifting.", "framework": null, "confidence": 0.9, "extraction": { "at": "2026-05-02 20:12:26.309+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 164, "frameworkName": "fraud-exposure" }, { "matchId": "2952e1d9-9e12-47a3-ac94-c3d95e3103a0", "evidence": "The slide explicitly frames the surgeon's behavior as 'finding excuses to jam payors' for high fees.", "framework": null, "confidence": 0.9, "extraction": { "at": "2026-05-02 20:12:26.356+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 168, "frameworkName": "fraud-exposure" }, { "matchId": "323b2654-c31c-47ea-8c24-025374014ccf", "evidence": "The slide explicitly frames a practice as 'off-label misuse' and 'not indicated' to expose potential risks or regulatory issues.", "framework": null, "confidence": 0.85, "extraction": { "at": "2026-05-02 20:12:26.941+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 171, "frameworkName": "fraud-exposure" }, { "matchId": "49cc82d1-9e1f-4347-86a5-152a0963a6db", "evidence": "The slide explicitly labels the company's business model as a 'scam' and uses internal quotes to prove it.", "framework": null, "confidence": 0.9, "extraction": { "at": "2026-05-02 20:12:28.667+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 175, "frameworkName": "fraud-exposure" }, { "matchId": "8497438a-85b7-4a1c-a27a-cbff907be1b8", "evidence": "The slide explicitly claims the trial 'cherrypicked' donors to 'manipulate the outcomes'.", "framework": null, "confidence": 0.9, "extraction": { "at": "2026-05-02 21:25:50.001+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 176, "frameworkName": "fraud-exposure" }, { "matchId": "73790b53-80ac-40c6-a79d-ac4337f9f989", "evidence": "Uses quotes from a top liver transplant surgeon to validate the argument.", "framework": null, "confidence": 0.9, "extraction": { "at": "2026-05-02 20:12:29.107+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 178, "frameworkName": "authority-citation" }, { "matchId": "59585f7b-6164-4d0d-906b-b25d2fe0a347", "evidence": "The text explicitly mentions 'merely the tip of the iceberg' to describe the gap between stated guidelines and actual practice.", "framework": null, "confidence": 0.9, "extraction": { "at": "2026-05-02 21:25:52.039+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 179, "frameworkName": "iceberg-model" }, { "matchId": "26166196-9b2c-4c39-9d97-226d67fe5897", "evidence": "The slide explicitly highlights discrepancies between trial data and real-world usage to question company claims and safety.", "framework": null, "confidence": 0.9, "extraction": { "at": "2026-05-02 20:12:29.491+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 181, "frameworkName": "fraud-exposure" }, { "matchId": "d7de5942-6fbb-4247-bebf-31fc7f53a2e9", "evidence": "The slide explicitly frames the user's behavior as 'textbook quackery' and 'disregard the FDA label' to expose potential misconduct.", "framework": null, "confidence": 0.9, "extraction": { "at": "2026-05-02 20:12:29.325+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 183, "frameworkName": "fraud-exposure" }, { "matchId": "59c9afb5-a522-4089-b2c5-094ff2f6704d", "evidence": "The slide explicitly frames the company's actions as 'off-label misuse' and 'hair-raising' to suggest regulatory or ethical non-compliance.", "framework": null, "confidence": 0.9, "extraction": { "at": "2026-05-02 20:12:29.579+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 185, "frameworkName": "fraud-exposure" }, { "matchId": "e27038d7-e6e8-4b05-94cf-6c9808f4e2fc", "evidence": "The slide explicitly contrasts the company's 'bull case' claim with expert testimony that contradicts the underlying mechanism.", "framework": null, "confidence": 0.9, "extraction": { "at": "2026-05-02 20:12:32.105+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 186, "frameworkName": "ceo-quote-contradiction" }, { "matchId": "3e778b56-67fe-4b17-b8d6-12fdd045475d", "evidence": "The slide explicitly frames the surgeon's quote as a 'striking display of contradiction'.", "framework": null, "confidence": 0.9, "extraction": { "at": "2026-05-02 20:12:30.353+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 187, "frameworkName": "expose_contradiction" }, { "matchId": "f2d80d1c-175e-4d84-8041-dfd449d1b085", "evidence": "The slide explicitly alleges kickbacks and Medicare fraud.", "framework": null, "confidence": 0.9, "extraction": { "at": "2026-05-02 20:12:32.082+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 189, "frameworkName": "fraud-exposure" }, { "matchId": "a4498887-e10a-4703-b044-7af5315e3168", "evidence": "The slide explicitly contrasts regulatory contraindications with expert testimony of widespread off-label use.", "framework": null, "confidence": 0.9, "extraction": { "at": "2026-05-02 20:12:34.123+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 191, "frameworkName": "fraud-exposure" }, { "matchId": "9997c5a4-80fa-4956-96b2-40a1aa000007", "evidence": "The slide contrasts the company's public image with internal claims of hiring unqualified surgeons.", "framework": null, "confidence": 0.9, "extraction": { "at": "2026-05-02 20:12:30.502+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 194, "frameworkName": "expose_contradiction" }, { "matchId": "add76684-e56a-4382-9028-70bd6d0d97ea", "evidence": "The slide frames TransMedics as an entity with poor quality control and hiring practices.", "framework": null, "confidence": 0.8, "extraction": { "at": "2026-05-02 20:12:31.049+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 198, "frameworkName": "antagonist-introduction" }, { "matchId": "8fbac61a-a29e-4c52-90a2-312ed97b209d", "evidence": "The slide presents testimony to allege systemic malpractice and dishonesty.", "framework": null, "confidence": 0.9, "extraction": { "at": "2026-05-02 20:12:31.752+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 201, "frameworkName": "fraud-exposure" }, { "matchId": "fb41b255-a7eb-478d-ab8d-86e1390058c9", "evidence": "The slide frames TransMedics surgeons as problematic/unlicensed to build a negative narrative.", "framework": null, "confidence": 0.8, "extraction": { "at": "2026-05-02 20:12:32.765+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 202, "frameworkName": "antagonist-introduction" }, { "matchId": "347caa3e-77f3-4ffa-99dc-3f572e479244", "evidence": "The slide explicitly frames the subject (TransMedics surgeons) as incompetent and a safety risk through negative expert testimony.", "framework": null, "confidence": 0.9, "extraction": { "at": "2026-05-02 20:12:32.149+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 204, "frameworkName": "antagonist-introduction" }, { "matchId": "65890d80-6e59-4840-bb3b-33da44903c8d", "evidence": "Uses direct executive testimony to highlight perceived quality regression and safety risks.", "framework": null, "confidence": 0.9, "extraction": { "at": "2026-05-02 20:12:38.408+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 207, "frameworkName": "ceo-quote-contradiction" }, { "matchId": "eb4c122a-b16b-4423-811c-18b956fcebd8", "evidence": "The slide explicitly attempts to expose a gap between company practice and customer perception regarding surgeon licensing.", "framework": null, "confidence": 0.9, "extraction": { "at": "2026-05-02 20:12:33.142+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 208, "frameworkName": "fraud-exposure" }, { "matchId": "85aa4352-a365-4ba2-a185-b754ce2175da", "evidence": "The slide explicitly contrasts expert testimony with official industry standards to allege misconduct.", "framework": null, "confidence": 0.9, "extraction": { "at": "2026-05-02 20:12:33.403+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 211, "frameworkName": "fraud-exposure" }, { "matchId": "6552ec20-af1b-4a32-813e-4c618172f139", "evidence": "The slide explicitly details an alleged scheme to circumvent regulatory credentialing requirements.", "framework": null, "confidence": 0.9, "extraction": { "at": "2026-05-02 20:12:34.275+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 212, "frameworkName": "fraud-exposure" }, { "matchId": "9b1654f8-80f3-4727-99fe-24089e4091e4", "evidence": "The slide presents expert testimony to contradict the implied legitimacy of TransMedics' surgical staffing practices.", "framework": null, "confidence": 0.9, "extraction": { "at": "2026-05-02 20:12:34.286+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 213, "frameworkName": "expose_contradiction" }, { "matchId": "6a441d11-5422-49b6-ba7c-3e3aeca0afef", "evidence": "The slide explicitly documents the company's association with a disgraced figure to expose a contradiction in their public narrative.", "framework": null, "confidence": 0.9, "extraction": { "at": "2026-05-02 20:12:35.091+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 221, "frameworkName": "fraud-exposure" }, { "matchId": "3c7db0bb-7ff1-468d-80d1-6ace43b05441", "evidence": "Juxtaposition of award-winning surgeon image with criminal allegations", "framework": null, "confidence": 0.8, "extraction": { "at": "2026-05-02 20:12:36.248+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 224, "frameworkName": "ceo-quote-contradiction" }, { "matchId": "9594ef1b-f75a-4b49-ae60-8966aab523f8", "evidence": "The slide explicitly links a professional to a known broker to expose potential unethical behavior.", "framework": null, "confidence": 0.9, "extraction": { "at": "2026-05-02 20:12:36.028+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 225, "frameworkName": "fraud-exposure" }, { "matchId": "e0eac642-a409-4f3e-9d1a-4bfe0d7da9a1", "evidence": "The slide explicitly frames TransMedics as a villain prioritizing revenue over safety.", "framework": null, "confidence": 0.9, "extraction": { "at": "2026-05-02 20:12:37.61+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 228, "frameworkName": "antagonist-introduction" }, { "matchId": "c2df9669-e3d3-4645-986e-7f55d96ff58c", "evidence": "The slide presents testimony to expose a contradiction between company claims and clinical practice.", "framework": null, "confidence": 0.8, "extraction": { "at": "2026-05-02 20:12:37.822+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 229, "frameworkName": "fraud-exposure" }, { "matchId": "688e916e-2c39-49c6-a647-a1995cf7bb54", "evidence": "The slide contrasts the implied standard of care (surgeon control) with the alleged reality (TransMedics control).", "framework": null, "confidence": 0.9, "extraction": { "at": "2026-05-02 20:12:37.785+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 232, "frameworkName": "expose_contradiction" }, { "matchId": "bd51fa38-3a6f-4712-9c07-267a69dc5570", "evidence": "The slide explicitly frames the content as 'smoking gun information' to expose unethical/fraudulent practices.", "framework": null, "confidence": 0.9, "extraction": { "at": "2026-05-02 20:12:37.582+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 234, "frameworkName": "fraud-exposure" }, { "matchId": "c86870f9-5e80-46b8-8137-7fdd542ab7df", "evidence": "The slide presents expert testimony to allege deceptive practices by the company.", "framework": null, "confidence": 0.9, "extraction": { "at": "2026-05-02 20:12:37.783+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 235, "frameworkName": "fraud-exposure" }, { "matchId": "d4ca22e6-fd98-48e3-93ad-4dbc4d5315a3", "evidence": "The slide explicitly aims to expose alleged incompetence and lack of medical licensing in a clinical process.", "framework": null, "confidence": 0.9, "extraction": { "at": "2026-05-02 20:12:37.957+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 238, "frameworkName": "fraud-exposure" }, { "matchId": "67d1f653-32d9-4d3b-b6d9-c1dc49dc23c7", "evidence": "The slide frames TransMedics as a negligent actor using a 'bait and switch' scheme.", "framework": null, "confidence": 0.9, "extraction": { "at": "2026-05-02 20:12:38.268+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 241, "frameworkName": "antagonist-introduction" }, { "matchId": "81a9ca0d-0f28-4c11-848a-f6fa98991b89", "evidence": "The slide explicitly frames the company's claim as a 'disingenuous ruse' and uses expert testimony to contradict it.", "framework": null, "confidence": 0.9, "extraction": { "at": "2026-05-02 20:12:38.358+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 242, "frameworkName": "fraud-exposure" }, { "matchId": "bfb33bce-8408-4e29-a2ae-126a3cc783d2", "evidence": "The slide frames the CEO as the antagonist through the reported hostile quote.", "framework": null, "confidence": 0.8, "extraction": { "at": "2026-05-02 20:12:38.784+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 248, "frameworkName": "antagonist-introduction" }, { "matchId": "3417c53c-3962-41fc-98a3-4bd2f14b22a9", "evidence": "The slide explicitly frames the CEO and management as the 'villain' or antagonist causing a 'death spiral'.", "framework": null, "confidence": 0.9, "extraction": { "at": "2026-05-02 20:12:40.213+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 250, "frameworkName": "antagonist-introduction" }, { "matchId": "685c5608-1011-4f52-88be-a1dcc64f2dcf", "evidence": "Uses expert testimony to allege predatory pricing and bait-and-switch tactics.", "framework": null, "confidence": 0.9, "extraction": { "at": "2026-05-02 21:25:50.298+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 252, "frameworkName": "fraud-exposure" }, { "matchId": "1bb07d58-5930-44c8-9cf9-ea3453623323", "evidence": "The slide contrasts favorable pump numbers with the reality of a necrotic liver, suggesting a systemic issue.", "framework": null, "confidence": 0.8, "extraction": { "at": "2026-05-02 21:25:52.827+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 262, "frameworkName": "ceo-quote-contradiction" }, { "matchId": "7d91698c-2129-44db-a940-c34ac3379050", "evidence": "The slide explicitly frames the content as exposing a lie by the company to cover up a product defect.", "framework": null, "confidence": 0.9, "extraction": { "at": "2026-05-02 21:25:53.901+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 263, "frameworkName": "fraud-exposure" }, { "matchId": "2f036c3c-0c2e-45df-a235-f3b235e92dfe", "evidence": "The slide uses a direct quote from an expert to contradict the company's transparency/claims.", "framework": null, "confidence": 0.9, "extraction": { "at": "2026-05-02 21:25:53.423+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 265, "frameworkName": "ceo-quote-contradiction" }, { "matchId": "f4905bc4-95b4-493f-875a-65f18875ec61", "evidence": "The slide explicitly frames the narrative as exposing unethical and potentially illegal business practices (extortion).", "framework": null, "confidence": 0.9, "extraction": { "at": "2026-05-02 21:25:55.579+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 267, "frameworkName": "fraud-exposure" }, { "matchId": "d778355c-c77e-4a9c-a8a6-07cd4a68a365", "evidence": "The slide explicitly contrasts the surgeon's experience with the CEO's claims.", "framework": null, "confidence": 0.95, "extraction": { "at": "2026-05-02 21:25:59.272+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 272, "frameworkName": "ceo-quote-contradiction" }, { "matchId": "a3a70d21-00df-48bd-afa4-8b76b301d215", "evidence": "The slide systematically presents negative testimonials to undermine the company's market position.", "framework": null, "confidence": 0.8, "extraction": { "at": "2026-05-02 21:25:56.95+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 275, "frameworkName": "villain-critique" }, { "matchId": "9f9648ac-c288-43dc-ab5f-f0264a5ff660", "evidence": "Citing a veteran transplant administrator at MGH to validate the claim.", "framework": null, "confidence": 0.9, "extraction": { "at": "2026-05-02 21:25:55.963+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 278, "frameworkName": "authority-citation" }, { "matchId": "f9b5bee0-aa8e-44ad-9196-731cacf0daff", "evidence": "Uses expert testimony to undermine the target company's market viability.", "framework": null, "confidence": 0.9, "extraction": { "at": "2026-05-02 21:26:00.571+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 280, "frameworkName": "preempt_rebuttal" }, { "matchId": "c5190229-caad-44be-9345-e7b21de96275", "evidence": "The slide frames TransMedics as a failing entity ('vaporware') compared to the established competitor LifePort.", "framework": null, "confidence": 0.9, "extraction": { "at": "2026-05-02 21:25:59.589+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 288, "frameworkName": "antagonist-introduction" }, { "matchId": "130a87cf-185a-41c2-a11d-c2a1cd704a80", "evidence": "The slide contrasts the company's commercialization of the product with internal expert testimony claiming it is ineffective.", "framework": null, "confidence": 0.9, "extraction": { "at": "2026-05-02 21:26:00.217+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 290, "frameworkName": "expose_contradiction" }, { "matchId": "1c68b054-92b4-49f1-9902-03643c000331", "evidence": "Uses a cardiac surgeon's credentials and FDA panel experience to validate the critique.", "framework": null, "confidence": 0.9, "extraction": { "at": "2026-05-02 21:26:05.371+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 295, "frameworkName": "authority-citation" }, { "matchId": "5dde01d7-e6c7-45f4-8707-3c85507a9f73", "evidence": "The slide systematically presents negative expert testimony to invalidate a specific business offering.", "framework": null, "confidence": 0.9, "extraction": { "at": "2026-05-02 21:26:03.164+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 300, "frameworkName": "preempt_rebuttal" }, { "matchId": "8cf44e10-109d-4c5f-b45e-ce94f347035e", "evidence": "The slide uses expert testimony to contradict the company's clinical value proposition.", "framework": null, "confidence": 0.9, "extraction": { "at": "2026-05-02 21:26:02.526+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 301, "frameworkName": "fraud-exposure" }, { "matchId": "d607c948-dfce-4689-96ca-fab2f81a729b", "evidence": "Uses expert surgeon testimonials to validate the bearish thesis.", "framework": null, "confidence": 0.9, "extraction": { "at": "2026-05-02 21:26:03.636+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 304, "frameworkName": "authority-citation" }, { "matchId": "68b67f49-86cf-4219-9d85-18a092de6529", "evidence": "Frames TransMedics as the 'villain' facing inevitable decline due to market competition.", "framework": null, "confidence": 0.9, "extraction": { "at": "2026-05-02 21:26:03.969+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 306, "frameworkName": "antagonist-introduction" }, { "matchId": "8578421f-37ef-49dd-be5c-d46aa3aa869a", "evidence": "Uses KOL/Surgeon testimony to validate competitive threat", "framework": null, "confidence": 0.9, "extraction": { "at": "2026-05-02 20:13:03.88+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 315, "frameworkName": "authority-citation" }, { "matchId": "d09578ae-b2aa-4c73-9cb2-bac66c2a206d", "evidence": "Use of KOL (Key Opinion Leader) quotes to validate competitive claims.", "framework": null, "confidence": 0.9, "extraction": { "at": "2026-05-02 20:13:03.665+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 316, "frameworkName": "authority-citation" }, { "matchId": "fe0406c2-15c3-4a63-9dd8-dd860cd31b69", "evidence": "The slide explicitly frames TransMedics as obsolete due to a cheaper, more effective alternative.", "framework": null, "confidence": 0.9, "extraction": { "at": "2026-05-02 20:13:05.213+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 318, "frameworkName": "villain-critique" }, { "matchId": "449bf090-0547-4873-b510-d5cf83e7be16", "evidence": "Frames TransMedics as the 'ridiculously high' cost villain compared to the efficient NRP technique.", "framework": null, "confidence": 0.9, "extraction": { "at": "2026-05-02 20:13:07.895+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 319, "frameworkName": "antagonist-introduction" }, { "matchId": "93956342-9354-4eff-9d04-4c3ffa67b27d", "evidence": "Comparing TransMedics pricing to the Hepatitis C drug market (Harvoni).", "framework": null, "confidence": 0.95, "extraction": { "at": "2026-05-02 20:13:02.714+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 325, "frameworkName": "argument-from-analogy" }, { "matchId": "dd7e6d00-70d2-4c67-b7a5-a38b79db5d43", "evidence": "Citing a transplant surgeon to validate market disruption claims.", "framework": null, "confidence": 0.9, "extraction": { "at": "2026-05-02 20:13:02.714+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 325, "frameworkName": "authority-citation" }, { "matchId": "bdb6615b-b9da-44eb-896a-b371777aaabc", "evidence": "The slide explicitly alleges a cover-up and device failure to damage the reputation of the company management.", "framework": null, "confidence": 0.9, "extraction": { "at": "2026-05-02 20:13:02.1+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 326, "frameworkName": "fraud-exposure" }, { "matchId": "b0f02f9c-1216-43bb-af84-e8e114a38bab", "evidence": "The slide systematically presents allegations of regulatory non-compliance and cover-ups.", "framework": null, "confidence": 0.9, "extraction": { "at": "2026-05-02 20:13:03.468+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 327, "frameworkName": "fraud-exposure" }, { "matchId": "5c807abe-4086-45fd-b4d8-ef7ff5a212f3", "evidence": "The slide presents testimony alleging systematic manipulation of safety data to deceive regulators.", "framework": null, "confidence": 0.9, "extraction": { "at": "2026-05-02 20:13:02.825+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 328, "frameworkName": "fraud-exposure" }, { "matchId": "d704ba21-8efe-4c0e-911f-e40cac0fbbf2", "evidence": "The slide systematically presents negative testimonials to challenge the company's public claims.", "framework": null, "confidence": 0.9, "extraction": { "at": "2026-05-02 20:13:02.761+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 330, "frameworkName": "fraud-exposure" }, { "matchId": "62cc08f4-61c0-4a6b-8557-ebd3cd2fa566", "evidence": "The slide explicitly contrasts manufacturer claims with expert testimony and visual evidence of physical damage.", "framework": null, "confidence": 0.9, "extraction": { "at": "2026-05-02 20:13:03.154+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 333, "frameworkName": "fraud-exposure" }, { "matchId": "07a25b0e-8f9b-4993-ade1-4da904fc07e6", "evidence": "Citing a Chief of transplant surgeon to validate claims against TransMedics.", "framework": null, "confidence": 0.9, "extraction": { "at": "2026-05-02 20:13:04.145+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 335, "frameworkName": "authority-citation" }, { "matchId": "ba5868b7-2538-47bf-9e38-8f5745c2c011", "evidence": "The slide explicitly frames the content as exposing a lie/cover-up by the company.", "framework": null, "confidence": 0.9, "extraction": { "at": "2026-05-02 20:13:06.906+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 336, "frameworkName": "fraud-exposure" }, { "matchId": "a38d810c-643c-4ab1-906b-66dce1424d0a", "evidence": "The slide explicitly frames the company's refusal to publish data as 'not being very honest' and a failure of responsibility.", "framework": null, "confidence": 0.9, "extraction": { "at": "2026-05-02 20:13:05.662+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 338, "frameworkName": "fraud-exposure" }, { "matchId": "02b1d6be-b7d5-4e3d-97ec-24bbcd540386", "evidence": "The slide explicitly frames the company's behavior as covering up device failures.", "framework": null, "confidence": 0.9, "extraction": { "at": "2026-05-02 20:13:06.126+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 340, "frameworkName": "fraud-exposure" } ], "patterns": [] }, "storymakers": null, "score": null, "review": null, "activistThesis": { "tone": "adversarial", "notes": "Scorpion Capital's signature 342-page long-form investigative short report, built around 30+ expert interviews (surgeons, OPO executives, ex-employees) presented as yellow-highlighted quote walls. Heavy use of profanity verbatim from sources, named villains throughout (CEO Waleed Hassanein, COO Tamer Khayal, CMO Magdy Attia, CEO's sister Amira Hassanein). Cover discloses Scorpion is short TMDX but does not disclose a numerical position size. Document explicitly previews a forthcoming FDA Citizen Petition seeking PMA suspension and a public letter to Congress — the call-to-action is regulatory, not just a financial short pitch. Layout is text-dense throughout with embedded screenshots, TMDX investor-day chart cutouts, and SEC-filing tables; minimal original data visualization. Distinctive Scorpion masthead and rhetorical voice (Mafia/Tony Soprano/Ozymandias analogies). Page references in TOC are 1-indexed against the PDF.", "kpisCited": [ { "detail": "$0 (Scorpion's intrinsic-value estimate)", "metric": "Target price" }, { "detail": "$401.2M (62.5% product / 37.5% service through 3Q24)", "metric": "LTM revenue" }, { "detail": "$108.8M — declined sequentially from $114.3M in 2Q24", "metric": "3Q24 revenue" }, { "detail": "7x — 'lofty even by speculative midcap metrics'", "metric": "EV / LTM revenue" }, { "detail": "10x — 'most expensive midcap medtech in the US, 3rd priciest overall' after ISRG and GKOS", "metric": "EV / product sales" }, { "detail": "$70-90K consumable, plus $50-300K in air transport fees", "metric": "Disposable price per case" }, { "detail": "$158M (largely aircraft) — no free cash flow", "metric": "LTM capex" }, { "detail": "~75% of US DCD heart, ~55% of US DCD liver done on OCS today", "metric": "DCD heart / liver share on OCS" }, { "detail": ">76% of liver transplants now shifted to daytime using OCS NOP (per TMDX investor day)", "metric": "Daytime liver transplant share" }, { "detail": "Fell from 60-70 cases (2020-2023) to 4 cases in 2024", "metric": "Vanderbilt OCS heart usage" }, { "detail": "Dropped ~60% per liver case when TransMedics is used", "metric": "Duke contribution margin per case" }, { "detail": "From $100-120K to $10K when device + NOP fees are included; private payors reimburse zero", "metric": "Per-case margin compression" }, { "detail": "UCSF, MGH, UCSD and Cedars-Sinai use ~255 OCS Liver units/year — ~10% of TMDX product revenue", "metric": "Concentration risk" }, { "detail": "Stepped outside open plan on 8/21 and 8/22, monetized 45,000 non-expiring options for $7M pre-tax — mid-Q3 2024", "metric": "CEO 10b5-1 trades" } ], "closingAsk": "Short TMDX and support Scorpion's forthcoming FDA Citizen Petition seeking suspension of the OCS Premarket Approval — transplant surgeons, hospital administrators and OPOs are invited to submit FDA comments via contact@scorpioncapital.com.", "extraction": { "at": "2026-04-22 22:33:12+00", "model": "unknown-legacy", "runId": null, "seconds": 203.34822, "promptVersion": null }, "scqaReward": "Target price $0. Even at an absurd 5x product-sales multiple the stock would sit in the $30s; the air-charter half is worthless and the accelerating customer exodus from Vanderbilt, MGH, UCSF and Cedars-Sinai is already collapsing 2025 revenue.", "thesisTypes": [ "fraud_exposure" ], "top3Reasons": [ "Allegedly a 'Mafia-style' Medicare billing-fraud and kickback racket exploiting an uncapped organ-acquisition reimbursement loophole", "Pre-eminent customers (Vanderbilt, MGH, UCSF, Cedars-Sinai, Duke) are eliminating or sharply curtailing OCS usage", "OCS device has no clinical benefit — used off-label as a 'surgeon lifestyle' tool, now disrupted by NRP, OrganOx and Paragonix at a fraction of the cost" ], "scqaSituation": "TransMedics sells the Organ Care System, an FDA-approved warm perfusion pump for lung, heart and liver transplants, paired with the National OCS Program — a fleet of private jets, procurement surgeons and device technicians billed back to Medicare via transplant centers.", "thesisSummary": "Scorpion Capital alleges TransMedics (TMDX) is the most extreme healthcare fraud they have encountered in 20 years of shorting — a 'Mafia-style' extortion scheme masquerading as a medical-device company. The Organ Care System (OCS), an FDA-approved warm perfusion pump for lung, heart and liver transplants, sells at $70-90K per consumable plus six-figure aircraft and procurement fees through the National OCS Program (NOP), exploiting an uncapped Medicare 'organ acquisition charge' loophole. Scorpion documents 30+ interviews with surgeons, OPO executives and ex-employees describing kickbacks to high-volume centers, off-label use, organ trafficking, billing fraud, and unreported device failures causing necrotic livers. Pre-eminent customers — Vanderbilt, MGH, UCSF, Cedars-Sinai, Duke — are eliminating or sharply curtailing usage as cheaper NRP, OrganOx and Paragonix alternatives arrive. Scorpion targets $0 and is filing an FDA Citizen Petition seeking PMA suspension of the OCS device.", "primaryDemands": [ "Short TMDX; target price $0 (100% downside)", "FDA suspension of Premarket Approval (PMA) for the Organ Care System (OCS) via a Citizen Petition", "Federal/state investigation of alleged Medicare billing fraud, kickbacks to high-volume transplant centers, off-label device use, and unreported device failures", "Transplant surgeons, hospital administrators and OPOs to submit supporting FDA comments" ], "scqaResolution": "Short the stock; file an FDA Citizen Petition demanding suspension of the OCS PMA; mobilize transplant surgeons, OPOs and federal/state authorities (DOJ, OIG, IRS, state AGs) to investigate alleged kickbacks, billing fraud and Medicare abuse.", "thesisOneLiner": "TransMedics is a Medicare billing-fraud and kickback racket whose top transplant-center customers are fleeing as cheaper alternatives arrive — Scorpion sets a $0 target.", "precedentsCited": [ "BlackBerry obsolescence trajectory (Vanderbilt surgeon analogy)", "Air Methods False Claims Act settlement and 2023 Chapter 11 (medical air transport precedent)", "Terren Peizer / Ontrak — first DOJ criminal conviction for 10b5-1 plan abuse" ], "scqaComplication": "Scorpion alleges the model is a Medicare billing-fraud and kickback racket: $70-90K consumables and six-figure flight fees with no clinical benefit, organ trafficking, off-label use, unreported device failures and an enraged customer base now defecting.", "narrativeInterest": 5, "notableSlidePages": [ 1, 12, 13, 16, 20 ], "peerCompaniesCited": [ "Intuitive Surgical (ISRG)", "Glaukos (GKOS)", "OrganOx", "Paragonix", "Trinity Air Medical", "Nationwide Organ Recovery Transport Alliance (NORA)", "Air Methods" ], "valuationFrameworks": [ "multiple_comparison", "sum_of_parts", "asset_value" ], "visualCraftInterest": 2 }, "pitchdeck": { "metadata": null, "profile": null }, "slides": [ { "page": 1, "type": "setup", "title": "The slide includes a call to action for stakeholders to contact the firm regarding an upcoming FDA Citizen Petition.", "function": "front_matter", "imagePath": "https://imgproxy.kitesheet.com/iZCwjqxCcrXYDvv03cpZPwxr_di6VlnzlyLGsaanVg4/rs:fit:1200:1200:0/q:82/f:webp/czM6Ly9raXRlc2hlZXQvY29ycHVzL3NsaWRlcy9lNWJmZmJhYWM3MDcvcDAwMS5wbmc", "rawType": "cover", "block": null, "metadata": { "slideType": "cover", "slideTypeCanon": { "name": "Cover", "slug": "cover", "status": "active", "canonId": "019de52d-05f2-729d-9f93-e0504f0a2410", "version": 1, "description": null }, "function": "front_matter", "functionCanon": { "name": "Front matter", "slug": "front_matter", "status": "active", "canonId": "019de52d-133d-73f0-9e26-201eda96b098", "version": 1, "description": null }, "density": "balanced", "densityScore": 37, "componentCount": 5, "textChars": 1093, "nDataPoints": 1, "notes": "The slide includes a call to action for stakeholders to contact the firm regarding an upcoming FDA Citizen Petition.", "elementsJson": [ "headline_text", "paragraph", "callout_box" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 21:25:44.173+00", "seconds": 2.723, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/1", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-1", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": { "h": 0.15, "w": 0.86, "x": 0.07, "y": 0.46 }, "kind": "callout", "text": "We are shortly filing a Citizen Petition with the FDA requesting suspension of PMA (Premarket Approval) of TransMedics Organ Care System (OCS), in conjunction with a public letter to members of Congress probing abuses in the US organ transplant system. Transplant surgeons, hospital administrators, OPO’s, or others wishing to submit FDA comments in support of the Petition may email us at contact@scorpioncapital.com or anonymously via the contact form on our site.", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": null, "subkind": { "name": "Primary callout", "slug": "primary", "status": "active", "canonId": "019de52c-fbd1-70eb-a9ce-8997f8674c1d", "version": 1, "description": null }, "framework": null }, "subkind": "primary", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:25:44.173+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "12ea95ec-d4e2-476b-b12a-c7d055adee4a", "parentComponentId": null }, { "bbox": null, "kind": "callout", "text": "We are shortly filing a Citizen Petition with the FDA requesting suspension of PMA (Premarket Approval) of TransMedics Organ Care System (OCS), in conjunction with a public letter to members of Congress probing abuses in the US organ transplant system.", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:45:57+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5372-7340-8f9b-a794dd24809a", "parentComponentId": null }, { "bbox": null, "kind": "metric", "text": "Target Price: $0", "attrs": null, "canon": { "kind": { "name": "Metric", "slug": "metric", "status": "active", "canonId": "019de52c-f923-73bf-8081-d0b1a8c5264d", "version": 1, "description": "Big-number or KPI value." }, "tool": { "name": "Quantification", "slug": "quantification", "status": "active", "bestFor": null, "canonId": "019dd9e1-47ab-72ce-a079-aab1f5299e88", "version": 1, "bodyDocId": null, "description": "Translating a claim into numbers, charts, or tables.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": "primary", "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:45:57+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5372-7340-8f9b-aab00c34cfbb", "parentComponentId": null }, { "bbox": { "h": 0.15, "w": 0.86, "x": 0.07, "y": 0.24 }, "kind": "paragraph", "text": "Walk Like An Egyptian: A “Mafia-Style” Extortion, Racketeering, And Organ Trafficking Scheme Masquerading As A Medical Device Company – Fueled By Kickbacks, Billing Fraud, Unreported Device Failures, And Off-Label Misuse On A Vast Scale; Precipitating A Customer Exodus And Rapidly Unfolding Death Spiral. Target Price: $0.", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:25:44.173+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "044462bc-5948-42f5-b553-5fdcd84b8d2a", "parentComponentId": null }, { "bbox": { "h": 0.04, "w": 0.68, "x": 0.07, "y": 0.16 }, "kind": "title", "text": "TRANSMEDICS GROUP INC (NASDAQ: TMDX)", "attrs": null, "canon": { "kind": { "name": "Title", "slug": "title", "status": "active", "canonId": "019de52c-f7dd-76d9-b848-b1f12bd85cf4", "version": 1, "description": "Slide title or headline." }, "tool": null, "subkind": { "name": "Headline", "slug": "headline", "status": "active", "canonId": "019de52c-fae1-7463-9a7c-d60668eced0d", "version": 1, "description": null }, "framework": null }, "subkind": "headline", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:25:44.173+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "9f67d9a4-3fc1-4894-8d43-2b1e033718da", "parentComponentId": null } ], "metrics": [], "tools": [ { "tool": { "name": "Call to action", "slug": "call-to-action", "status": "active", "bestFor": null, "canonId": "019dd9e1-4bbb-702a-9ead-82daf188bb7c", "version": 1, "bodyDocId": null, "description": "Explicit prescription of what the audience should do next.", "familyLabel": null, "categoryName": null, "categorySlug": null }, "agent": null, "layer": "slide", "agents": null, "matchId": "58e95065-0c9b-4577-a7f4-bf7aac6b1818", "evidence": "callout/primary: We are shortly filing a Citizen Petition with the FDA requesting suspension of PMA (Premarket Approval) of TransMedics Organ Care System (OCS), in conjunction with a public letter to members of Congress probing", "pageRefs": null, "priority": null, "whenToUse": null, "confidence": 0.7, "extraction": { "at": "2026-07-16 23:10:27.483934+00", "model": "or:meta-llama/llama-4-scout", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 1, "whyItWorks": null, "antipattern": null, "cardinality": "common", "narrativePurpose": null }, { "tool": { "name": "Slide recipe: Cover", "slug": "cover-slide", "status": "active", "bestFor": null, "canonId": "019df269-2a08-767d-9128-e7431e6fe8a3", "version": 1, "bodyDocId": "019df269-29e5-7738-b5fa-6892e5dc8e65", "description": "The first ten seconds. Build it deliberately.", "familyLabel": "slide-recipe", "categoryName": "Slide", "categorySlug": "slide" }, "agent": "designer", "layer": "slide", "agents": [ "designer" ], "matchId": "685d2fc8-8cb3-4e0a-94df-34f1e471c521", "evidence": "type: cover", "pageRefs": null, "priority": null, "whenToUse": null, "confidence": 0.9, "extraction": { "at": "2026-07-16 23:10:27.450203+00", "model": "or:meta-llama/llama-4-scout", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 1, "whyItWorks": null, "antipattern": null, "cardinality": null, "narrativePurpose": null } ], "frameworks": [], "arcBeats": [], "loops": [], "thumbSrc": "https://imgproxy.kitesheet.com/1nqdeXSG98tjiz3aAgMZIOyI8655HKDpIspmB8nJCB4/rs:fit:480:480:0/q:78/f:webp/czM6Ly9raXRlc2hlZXQvY29ycHVzL3NsaWRlcy9lNWJmZmJhYWM3MDcvcDAwMS5wbmc", "imagePathAlt": "https://imgproxy.kitesheet.com/WGr2FB9E4n0KXe1mA4YGWnIFrT7J14g8JdQczCzcrDc/rs:fit:1200:1200:0/q:82/f:webp/czM6Ly9raXRlc2hlZXQvY29ycHVzL3NsaWRlcy9lNWJmZmJhYWM3MDcvcDAwMS5qcGc", "thumbSrcAlt": "https://imgproxy.kitesheet.com/wpjEjgv8ZLO1ZtdIfI7DS3lmktd4PUCzSaWJZedsV6w/rs:fit:480:480:0/q:78/f:webp/czM6Ly9raXRlc2hlZXQvY29ycHVzL3NsaWRlcy9lNWJmZmJhYWM3MDcvcDAwMS5qcGc" }, { "page": 2, "type": "setup", "function": "other", "rawType": "appendix_disclosure", "block": null, "metadata": { "slideType": "appendix_disclosure", "slideTypeCanon": { "name": "Appendix disclosure", "slug": "appendix_disclosure", "status": "active", "canonId": "019de52d-07b2-7549-8e8b-932a19f6e616", "version": 1, "description": null }, "function": "other", "functionCanon": { "name": "Other (fallback)", "slug": "other", "status": "active", "canonId": "019de52d-15e1-75bc-99dc-07732380e2ce", "version": 1, "description": null }, "density": "balanced", "densityScore": 42, "componentCount": 2, "textChars": 5229, "nDataPoints": 0, "notes": null, "elementsJson": [ "paragraph" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 21:25:46.661+00", "seconds": 5.131, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/2", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-2", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": { "h": 0.735, "w": 0.852, "x": 0.074, "y": 0.165 }, "kind": "disclaimer", "text": "Scorpion Capital LLC is short TransMedics Group Inc. (\"TMDX\") (possibly along with or through its principals, members, partners, affiliates, employees, consultants, clients, investors, and/or related party entities or vehicles) and therefore stands to realize significant gains in the event that the price of its stock, bonds, options, and/or other securities decline or change. Although Scorpion Capital LLC does not expect to announce in the future any changes to its opinion concerning TMDX, that is subject to change at any time. Following publication of this report, Scorpion Capital LLC (and/or its principals, members, partners, affiliates, employees, consultants, clients, investors, and/or related party entities or vehicles) intends to continue transacting in TMDX's stock, and may cover its short position and/or be long, short, or neutral at any time hereafter regardless of the views stated herein, without regard to, and at prices that may diverge significantly from, any target price. This report is for informational purposes only and does not constitute investment advice or a recommendation to purchase or sell any particular security or to pursue any particular investment or trading strategy. You agree that your use of Scorpion Capital LLC's research is at your own risk. You further agree to do your own research and due diligence before making any investment decision with respect to securities covered herein. You represent to Scorpion Capital LLC that you have sufficient investment sophistication to critically assess the information, analysis and opinions in this report. Prior to making any investment, you should consult with professional financial, legal and tax advisors to assist in due diligence as may be appropriate and determine the appropriateness of the risk associated with a particular investment. Scorpion Capital LLC cannot guarantee that any projection or opinion expressed in this report will be realized. Our opinions are held in good faith, and Scorpion Capital LLC has based them on the public information, sources, the interviewed individuals, and any social media posts cited in this report, but Scorpion Capital LLC cannot and does not provide any representations or warranties with respect to the accuracy of those materials. In no event shall Scorpion Capital LLC or any of its affiliates be liable for any claims, losses, costs or damages of any kind, including direct, indirect, punitive, exemplary, incidental, special or, consequential damages, arising out of or in any way connected with any information in this report. We believe the experts we spoke with are reliable sources of information with respect to TMDX. However, we cannot and do not provide any representations or warranties with respect to the accuracy of the information they have provided to us. The quotations of experts used in this article do not reflect all information they have shared with us, including, without limitation, certain positive comments and experiences with respect to TMDX. In addition, the experts have typically received compensation for their conversations with us and may have conflicts of interest or other biases with respect to TMDX, which may give them an incentive to provide us with inaccurate, incomplete or otherwise prejudiced information. The former employees of TMDX that we spoke with are by definition separated from the company and thus the information they have provided may be outdated. All experts agreed, both in writing and orally, to not provide any material non-public information or any information that they are obligated to keep confidential, and that their service as a consultant or their participation in our research calls does not violate any confidentiality agreement or other obligation they have with their employer or any person or entity. The quotations of experts used in this article are based on Scorpion Capital LLC conversations with such experts and may be paraphrased, truncated, and/or summarized solely at our discretion, and do not always represent a precise transcript of those conversations. We have not conducted any diligence or other verification with respect to any social media posts included in this article with respect to TMDX. Thus, we cannot and do not provide any representations or warranties with respect to the accuracy of such social media posts. Any social media posts used in this article may not reflect all information the persons posting have shared on social media, including, without limitation, certain positive comments and experiences with respect to TMDX. In addition, the persons posting may have conflicts of interest or other biases with respect to TMDX, which may give them an incentive to post inaccurate, incomplete or otherwise prejudiced information on social media. Our target price represents our opinion of the intrinsic value of the company's shares, which may diverge significantly from their quoted market value; and we may cover our short position and/or be long, short, or neutral at any time, at market prices significantly different than our target price.", "attrs": null, "canon": { "kind": { "name": "Disclaimer", "slug": "disclaimer", "status": "active", "canonId": "91173477-d91f-4024-bbaf-d4f93e3f82dc", "version": 1, "description": "Legal/cautionary text that occupies most of the body of its slide." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:25:46.661+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "8fa6edc3-923d-4a02-9914-ede1acb662e4", "parentComponentId": null }, { "bbox": { "h": 0.035, "w": 0.852, "x": 0.074, "y": 0.125 }, "kind": "title", "text": "DISCLOSURES - THIS REPORT REPRESENTS THE CURRENT OPINIONS OF SCORPION CAPITAL LLC CONCERNING TRANSMEDICS GROUP INC. (STOCK TICKER: TMDX).", "attrs": null, "canon": { "kind": { "name": "Title", "slug": "title", "status": "active", "canonId": "019de52c-f7dd-76d9-b848-b1f12bd85cf4", "version": 1, "description": "Slide title or headline." }, "tool": null, "subkind": { "name": "Headline", "slug": "headline", "status": "active", "canonId": "019de52c-fae1-7463-9a7c-d60668eced0d", "version": 1, "description": null }, "framework": null }, "subkind": "headline", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:25:46.661+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "3d508aa9-1cf7-43c6-a02e-5c6368b95f30", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [], "arcBeats": [], "loops": [], "locked": true }, { "page": 3, "type": "tension", "title": "The slide uses anecdotal evidence to frame the company's leadership as a 'villain' figure, specifically highlighting potential legal and regulatory scrutiny.", "function": "name_villain", "rawType": "testimonial", "block": null, "metadata": { "slideType": "testimonial", "slideTypeCanon": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52d-0a2d-7782-8a48-7e84df92cc97", "version": 1, "description": null }, "function": "name_villain", "functionCanon": { "name": "Name villain", "slug": "name_villain", "status": "active", "canonId": "019de52d-1746-70d6-bc58-5eeaf5865526", "version": 1, "description": null }, "density": "balanced", "densityScore": 48, "componentCount": 5, "textChars": 2526, "nDataPoints": 0, "notes": "The slide uses anecdotal evidence to frame the company's leadership as a 'villain' figure, specifically highlighting potential legal and regulatory scrutiny.", "elementsJson": [ "quote_block" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 21:25:44.822+00", "seconds": 3.255, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/3", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-3", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "It’s like racketeering or something, right? That’s what it feels like...I’m sure other surgeons have used some pretty dramatic words...they’re playing like mafia-style...very deliberate and a thug-style way of getting things done.", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-23 01:18:10+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-70f3-714d-84be-95824a8f1809", "parentComponentId": null }, { "bbox": { "h": 0.15, "w": 0.7, "x": 0.15, "y": 0.42 }, "kind": "quote", "text": "You should see Waleed arrive at conferences. They show up in these blacked-out cars...and you think the president is showing up. It’s like Waleed and his secret service, but it’s the TransMedics folks.", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:25:44.822+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "b0f0e115-e027-49b9-bfc7-88a386e4c34a", "parentComponentId": null }, { "bbox": { "h": 0.2, "w": 0.7, "x": 0.15, "y": 0.12 }, "kind": "quote", "text": "It’s like racketeering or something, right? That’s what it feels like...I’m sure other surgeons have used some pretty dramatic words...they’re playing like mafia-style...very deliberate and a thug-style way of getting things done...", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:25:44.822+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "b13a106a-957d-4f42-847a-4e752f1e4f1d", "parentComponentId": null }, { "bbox": { "h": 0.2, "w": 0.7, "x": 0.15, "y": 0.65 }, "kind": "quote", "text": "There’s so much that’s going to be found out. Do you know everything that’s going on with the OIG and the DOJ and the IRS?...I recently interviewed with the Department of Justice, the OIG, and the IRS.", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:25:44.822+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "d9b3ead4-d102-426b-a1e7-9897d4e35818", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "\"It’s like racketeering or something, right? That’s what it feels like...I’m sure other surgeons have used some pretty dramatic words...they’re playing like mafia-style...very deliberate and a thug-style way of getting things done...I would call him Waleed’s enforcer. He’s someone you wouldn’t be surprised to find out is knee-capping people...you see those movies where the guys go around and collect their protection money. That’s what he reminds me of - the guy who’s going around to collect the protection money.\" — Transplant surgeon at a high-volume academic center; one of TransMedics largest customers; in process of moving to another device. \"You should see Waleed arrive at conferences. They show up in these blacked-out cars...and you think the president is showing up. It’s like three blacked-out SUVs. They all get out. They all look the same in their suits. Yeah, it’s like Waleed and his secret service, but it’s the TransMedics folks.\" — Executive at a leading OPO (Organ Procurement Organization), industry veteran. \"There’s so much that’s going to be found out. Do you know everything that’s going on with the OIG and the DOJ and the IRS?...it’s deeper than [the Washington Post], and I’ll let you know because I’ve been interviewed for it...here’s all the drama. I recently interviewed with the Department of Justice, the OIG, and the IRS. And with the DOJ out of Washington and out of New York...and then the state attorney general is getting involved in this as well because if there’s Medicare fraud...and probably the most prominent attorney general that’s getting involved is Virginia.\" — CEO of a major OPO, longtime industry executive.", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-23 01:18:10+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-70f3-714d-84be-9ad4ea66d65e", "parentComponentId": null } ], "metrics": [], "tools": [ { "tool": { "name": "Emotional Appeal", "slug": "emotional-appeal", "status": "active", "bestFor": null, "canonId": "019dd956-bde9-7668-8be7-0097678fec59", "version": 1, "bodyDocId": null, "description": "Connecting to audience feelings rather than just logic", "familyLabel": null, "categoryName": "Slide", "categorySlug": "slide" }, "agent": "Storyteller", "layer": "slide", "agents": [ "Storyteller" ], "matchId": "e4d974f7-ac1b-4241-8084-b99d3932b47c", "evidence": "quote: \"It's like racketeering or something, right? That's what it feels like...I'm sure other surgeons have used some pretty dramatic words...they're playing like mafia-style...very deliberate and a thug-style way of getting business.\"", "pageRefs": null, "priority": null, "whenToUse": null, "confidence": 0.7, "extraction": { "at": "2026-07-16 23:10:27.581897+00", "model": "or:meta-llama/llama-4-scout", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 3, "whyItWorks": null, "antipattern": null, "cardinality": null, "narrativePurpose": null } ], "frameworks": [ { "matchId": "776e7252-7147-40e8-ad3b-e4f101cfd672", "evidence": "The slide explicitly frames the company leadership as a 'villain' or 'thug' to build a case against them.", "framework": null, "confidence": 0.9, "extraction": { "at": "2026-05-02 21:25:44.822+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 3, "frameworkName": "antagonist-introduction" } ], "arcBeats": [ { "to": 9, "arc": { "name": "Overcoming the Monster", "slug": "overcoming-monster", "status": "active", "bestFor": "Competitive positioning, rallying teams", "canonId": "019dd956-6339-76ac-9cbf-4b377c3aa89e", "version": 1, "bodyDocId": "019df22a-2356-73eb-8061-d8c81dc0aa49", "structure": "The Monster -> The Call -> The Struggle -> The Victory -> The New Order", "description": null, "familyLabel": null }, "from": 3, "name": "Testimonials from Industry Experts", "beatId": "2ce2729c-3fa0-4258-b23a-c05ff53032bc", "matchId": "d22e2123-5207-45f3-8f91-8fe159736ca7", "beatType": null, "evidence": "The section presents testimonials from experts and industry professionals criticizing TransMedics Group Inc.", "position": 2, "isPrimaryArc": true, "parentBeatType": null, "alignedBlockIds": null, "matchConfidence": 0.8 } ], "loops": [], "locked": true }, { "page": 4, "type": "tension", "title": "The slide uses quotes to build a narrative of corporate malfeasance and systemic gaming of organ allocation processes.", "function": "expose_contradiction", "rawType": "testimonial", "block": null, "metadata": { "slideType": "testimonial", "slideTypeCanon": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52d-0a2d-7782-8a48-7e84df92cc97", "version": 1, "description": null }, "function": "expose_contradiction", "functionCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-171f-776f-887c-73edaff4cf9c", "version": 1, "description": null }, "density": "balanced", "densityScore": 46, "componentCount": 4, "textChars": 3210, "nDataPoints": 0, "notes": "The slide uses quotes to build a narrative of corporate malfeasance and systemic gaming of organ allocation processes.", "elementsJson": [ "quote_block" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 21:25:44.785+00", "seconds": 2.444, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/4", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-4", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "everything at this company feels like a big secret, and it’s really weird and sketchy.", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:45:51+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5372-7340-8f99-5aee6abdaae4", "parentComponentId": null }, { "bbox": { "h": 0.25, "w": 0.7, "x": 0.15, "y": 0.6 }, "kind": "quote", "text": "“...they are intentionally keeping people in these dark silos so that people don’t have a grasp of what’s going on...it’s just like this weird lack of transparency, this weird secretive culture, and it just felt like everyone is intentionally kept in the dark so that any sort of information couldn’t be used against the company in any way. And Waleed was always like if anyone has questions, refer them back to us...the pilots were like, “We were told not to talk to you guys”...everything at this company feels like a big secret, and it’s really weird and sketchy.” - Former employee who left recently", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:25:44.785+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "cf589c6f-8f06-47d6-8d64-7c6593b054d8", "parentComponentId": null }, { "bbox": { "h": 0.35, "w": 0.7, "x": 0.15, "y": 0.15 }, "kind": "quote", "text": "“If that gets revealed, if that gets exposed in any way, that’s curtains...I have known of some sites in our region that would get these kinds of calls...this kind of hotline for organs...it allowed them consequently to boost their numbers substantially...We scratch our heads wondering how in the heck did these guys get these organs? How did that happen?...There’s a lot of game-playing going on out there...they would come from, say, Tennessee...literally a sort of hotline...asking if they want an organ...it just stopped being part of the formal allocation process. This kind of thing, I suspect, is actually happening much more frequently than we know...I think this is how some centers get ahead in their numbers. It’s a below the radar screen kind of arrangement...it’s kind of like one way of getting the good stuff, so to speak...” – Transplant hepatologist at Massachusetts General Hospital; MGH stated their entire usage of TransMedics is at risk", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:25:44.785+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "db927733-735e-4197-bb4b-f53fb842b07f", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "“If that gets revealed, if that gets exposed in any way, that’s curtains...I have known of some sites in our region that would get these kinds of calls...this kind of hotline for organs...it allowed them consequently to boost their numbers substantially...We scratch our heads wondering how in the heck did these guys get these organs? How did that happen?...There’s a lot of game-playing going on out there...they would come from, say, Tennessee...literally a sort of hotline...asking if they want an organ...it just stopped being part of the formal allocation process. This kind of thing, I suspect, is actually happening much more frequently than we know...I think this is how some centers get ahead in their numbers. It’s a below the radar screen kind of arrangement...it’s kind of like one way of getting the good stuff, so to speak...” — Transplant hepatologist at Massachusetts General Hospital; MGH stated their entire usage of TransMedics is at risk. “...they are intentionally keeping people in these dark silos so that people don’t have a grasp of what’s going on...it’s just like this weird lack of transparency, this weird secretive culture, and it just felt like everyone is intentionally kept in the dark so that any sort of information couldn’t be used against the company in any way. And Waleed was always like if anyone has questions, refer them back to us...the pilots were like, “We were told not to talk to you guys”...everything at this company feels like a big secret, and it’s really weird and sketchy.” — Former employee who left recently", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:45:51+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5372-7340-8f99-5de38af3f683", "parentComponentId": null } ], "metrics": [], "tools": [ { "tool": { "name": "Anaphora", "slug": "anaphora", "status": "active", "bestFor": null, "canonId": "019dd956-9fee-74aa-a920-078aa44132c0", "version": 1, "bodyDocId": null, "description": "Repeating words at the beginning of successive clauses for rhythm", "familyLabel": null, "categoryName": "Loop", "categorySlug": "loop" }, "agent": "Storyteller", "layer": "slide", "agents": [ "Storyteller" ], "matchId": "bf70f3c4-9369-439e-8f4f-d22471697ab5", "evidence": "quote/testimonial: \"If that gets revealed, if that gets exposed in any way, that's curtains...I have known of some sites in our region that would get these kinds of calls...this kind of hotline for organs...it allowed them consequently...\".", "pageRefs": null, "priority": null, "whenToUse": null, "confidence": 0.7, "extraction": { "at": "2026-07-16 23:10:27.646681+00", "model": "or:meta-llama/llama-4-scout", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 4, "whyItWorks": null, "antipattern": null, "cardinality": null, "narrativePurpose": null } ], "frameworks": [], "arcBeats": [ { "to": 9, "arc": { "name": "Overcoming the Monster", "slug": "overcoming-monster", "status": "active", "bestFor": "Competitive positioning, rallying teams", "canonId": "019dd956-6339-76ac-9cbf-4b377c3aa89e", "version": 1, "bodyDocId": "019df22a-2356-73eb-8061-d8c81dc0aa49", "structure": "The Monster -> The Call -> The Struggle -> The Victory -> The New Order", "description": null, "familyLabel": null }, "from": 3, "name": "Testimonials from Industry Experts", "beatId": "2ce2729c-3fa0-4258-b23a-c05ff53032bc", "matchId": "d22e2123-5207-45f3-8f91-8fe159736ca7", "beatType": null, "evidence": "The section presents testimonials from experts and industry professionals criticizing TransMedics Group Inc.", "position": 2, "isPrimaryArc": true, "parentBeatType": null, "alignedBlockIds": null, "matchConfidence": 0.8 } ], "loops": [], "locked": true }, { "page": 5, "type": "evidence", "title": "The quote highlights a conflict between administrative credit holds and urgent clinical needs for heart transplants.", "function": "illustrate_case", "rawType": "testimonial", "block": null, "metadata": { "slideType": "testimonial", "slideTypeCanon": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52d-0a2d-7782-8a48-7e84df92cc97", "version": 1, "description": null }, "function": "illustrate_case", "functionCanon": { "name": "Illustrate case", "slug": "illustrate_case", "status": "active", "canonId": "019de52d-13b4-772c-bb73-1873612a7463", "version": 1, "description": null }, "density": "balanced", "densityScore": 40, "componentCount": 3, "textChars": 2322, "nDataPoints": 0, "notes": "The quote highlights a conflict between administrative credit holds and urgent clinical needs for heart transplants.", "elementsJson": [ "quote_block" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 21:25:44.614+00", "seconds": 2.052, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/5", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-5", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "I cannot stand working with them. It feels like I’m talking to a used car salesman...We had a recent situation, where we had some A/R...they declined a heart transplant for one of our patients in the ICU because of this credit hold.", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:45:50+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5372-7340-8f99-1555bf2408a7", "parentComponentId": null }, { "bbox": { "h": 0.4, "w": 0.7, "x": 0.15, "y": 0.3 }, "kind": "quote", "text": "“I cannot stand working with them. It feels like I’m talking to a used car salesman...We had a recent situation, where we had some A/R...they declined a heart transplant for one of our patients in the ICU because of this credit hold. They refused to go out and get the heart for us. I could not believe it...I had to spend probably eight hours of my week on the phone with their rep, trying to beg and plead with them to release the hold because we didn’t want to miss an opportunity to get an organ for one of our patients...I felt like I was groveling...these heart patients, this isn’t like a kidney transplant. This person is in the ICU. They’re going to die. They’re status one. They’re getting this organ offer because they’re the sickest patient in need of one, and TransMedics made that call. It was their COO [sic], Tamer Khayal, who is not a clinician...[Magdy Attia] was part of the people threatening us.” – Administrator at a pre-eminent academic transplant center, which expects to eliminate TransMedics usage staring in early 2025", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:25:44.614+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "74edd4da-0752-4718-9edd-2dcf1c54b303", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "“I cannot stand working with them. It feels like I’m talking to a used car salesman...We had a recent situation, where we had some A/R...they declined a heart transplant for one of our patients in the ICU because of this credit hold. They refused to go out and get the heart for us. I could not believe it...I had to spend probably eight hours of my week on the phone with their rep, trying to beg and plead with them to release the hold because we didn’t want to miss an opportunity to get an organ for one of our patients...I felt like I was groveling...these heart patients, this isn’t like a kidney transplant. This person is in the ICU. They’re going to die. They’re status one. They’re getting this organ offer because they’re the sickest patient in need of one, and TransMedics made that call. It was their COO [sic], Tamer Khayal, who is not a clinician...[Magdy Attia] was part of the people threatening us.” — Administrator at a pre-eminent academic transplant center, which expects to eliminate TransMedics usage staring in early 2025", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:45:50+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5372-7340-8f99-1871645e8180", "parentComponentId": null } ], "metrics": [], "tools": [ { "tool": { "name": "Villain slide", "slug": "villain-slide", "status": "active", "bestFor": "In activist decks where the personality matters", "canonId": "019dd9e1-518c-7404-976a-5be5a517b659", "version": 1, "bodyDocId": null, "description": "A dedicated slide presenting the named villain visually", "familyLabel": null, "categoryName": null, "categorySlug": null }, "agent": null, "layer": "slide", "agents": null, "matchId": "bff3e90b-8e58-4bbc-bcd7-72cb97b6603c", "evidence": "The slide presents a strongly negative view of a company, using phrases like 'I cannot stand working with them' and 'it feels like I'm talking to a used car salesman', which are typical characteristics of a villain slide.", "pageRefs": null, "priority": null, "whenToUse": "In activist decks where the personality matters", "confidence": 0.9, "extraction": { "at": "2026-07-16 23:10:25.483959+00", "model": "or:meta-llama/llama-4-scout", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 5, "whyItWorks": "Makes the antagonist concrete", "antipattern": null, "cardinality": null, "narrativePurpose": null } ], "frameworks": [], "arcBeats": [ { "to": 9, "arc": { "name": "Overcoming the Monster", "slug": "overcoming-monster", "status": "active", "bestFor": "Competitive positioning, rallying teams", "canonId": "019dd956-6339-76ac-9cbf-4b377c3aa89e", "version": 1, "bodyDocId": "019df22a-2356-73eb-8061-d8c81dc0aa49", "structure": "The Monster -> The Call -> The Struggle -> The Victory -> The New Order", "description": null, "familyLabel": null }, "from": 3, "name": "Testimonials from Industry Experts", "beatId": "2ce2729c-3fa0-4258-b23a-c05ff53032bc", "matchId": "d22e2123-5207-45f3-8f91-8fe159736ca7", "beatType": null, "evidence": "The section presents testimonials from experts and industry professionals criticizing TransMedics Group Inc.", "position": 2, "isPrimaryArc": true, "parentBeatType": null, "alignedBlockIds": null, "matchConfidence": 0.8 } ], "loops": [], "locked": true }, { "page": 6, "type": "tension", "title": "The slide uses a direct quote to expose a contradiction between company claims and user experience.", "function": "expose_contradiction", "rawType": "testimonial", "block": null, "metadata": { "slideType": "testimonial", "slideTypeCanon": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52d-0a2d-7782-8a48-7e84df92cc97", "version": 1, "description": null }, "function": "expose_contradiction", "functionCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-171f-776f-887c-73edaff4cf9c", "version": 1, "description": null }, "density": "balanced", "densityScore": 40, "componentCount": 3, "textChars": 2379, "nDataPoints": 0, "notes": "The slide uses a direct quote to expose a contradiction between company claims and user experience.", "elementsJson": [ "quote_block" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 21:25:45.139+00", "seconds": 2.255, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/6", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-6", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "‘Wow, yours is the only center that is having these issues,’ which is an outright lie… it’s just a fucking lie. It’s a lie that we’re the only center that’s having these problems but that was the communication to us.", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:45:51+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5372-7340-8f99-33f1452f8d4a", "parentComponentId": null }, { "bbox": { "h": 0.4, "w": 0.7, "x": 0.15, "y": 0.3 }, "kind": "quote", "text": "“There was a liver a month ago...it was an infarction, that part of it had died...one of my colleagues was already at a point of no return in the recipient operation. He had already started before realizing that this was happening...we ended up having to use that liver and, sure enough, post-transplant...the right lobe of the liver just was completely dead...The [TransMedics] procuring surgeon could feel it, but it was not reported...that’s just the first part of the story. Fast forward three weeks later, another colleague, we had another liver on pump for a different patient...and again, this time, the right lobe of the liver felt off...we called TransMedics...we’re nervous because of what happened with our previous patient...the response was ‘Wow, yours is the only center that is having these issues,’ which is an outright lie... it’s just a fucking lie. It’s a lie that we’re the only center that’s having these problems but that was the communication to us.” – Head of transplant surgery at a major center; high-volume TransMedics user, who intends to terminate usage", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:25:45.139+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "63a07f6c-a89c-4815-8fff-71cfaeb6ed46", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "“There was a liver a month ago...it was an infarction, that part of it had died...one of my colleagues was already at a point of no return in the recipient operation. He had already started before realizing that this was happening...we ended up having to use that liver and, sure enough, post-transplant...the right lobe of the liver just was completely dead... The [TransMedics] procuring surgeon could feel it, but it was not reported...that’s just the first part of the story. Fast forward three weeks later, another colleague, we had another liver on pump for a different patient...and again, this time, the right lobe of the liver felt off...we called TransMedics...we’re nervous because of what happened with our previous patient...the response was ‘Wow, yours is the only center that is having these issues,’ which is an outright lie… it’s just a fucking lie. It’s a lie that we’re the only center that’s having these problems but that was the communication to us.” — Head of transplant surgery at a major center; high-volume TransMedics user, who intends to terminate usage", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:45:51+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5372-7340-8f99-354bb3ea2f71", "parentComponentId": null } ], "metrics": [], "tools": [ { "tool": { "name": "Villain slide", "slug": "villain-slide", "status": "active", "bestFor": "In activist decks where the personality matters", "canonId": "019dd9e1-518c-7404-976a-5be5a517b659", "version": 1, "bodyDocId": null, "description": "A dedicated slide presenting the named villain visually", "familyLabel": null, "categoryName": null, "categorySlug": null }, "agent": null, "layer": "slide", "agents": null, "matchId": "d6828756-6a48-486b-ae5e-cb3720dccf36", "evidence": "This slide also presents a negative testimonial, which could be seen as part of a villain narrative, but it's less clear than slide 1.", "pageRefs": null, "priority": null, "whenToUse": "In activist decks where the personality matters", "confidence": 0.8, "extraction": { "at": "2026-07-16 23:10:25.571347+00", "model": "or:meta-llama/llama-4-scout", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 6, "whyItWorks": "Makes the antagonist concrete", "antipattern": null, "cardinality": null, "narrativePurpose": null } ], "frameworks": [ { "matchId": "d6b02247-3785-4b5a-871e-a28e766b3eb1", "evidence": "The slide uses a customer quote to directly contradict the company's stated position.", "framework": null, "confidence": 0.9, "extraction": { "at": "2026-05-02 21:25:45.139+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 6, "frameworkName": "ceo-quote-contradiction" } ], "arcBeats": [ { "to": 9, "arc": { "name": "Overcoming the Monster", "slug": "overcoming-monster", "status": "active", "bestFor": "Competitive positioning, rallying teams", "canonId": "019dd956-6339-76ac-9cbf-4b377c3aa89e", "version": 1, "bodyDocId": "019df22a-2356-73eb-8061-d8c81dc0aa49", "structure": "The Monster -> The Call -> The Struggle -> The Victory -> The New Order", "description": null, "familyLabel": null }, "from": 3, "name": "Testimonials from Industry Experts", "beatId": "2ce2729c-3fa0-4258-b23a-c05ff53032bc", "matchId": "d22e2123-5207-45f3-8f91-8fe159736ca7", "beatType": null, "evidence": "The section presents testimonials from experts and industry professionals criticizing TransMedics Group Inc.", "position": 2, "isPrimaryArc": true, "parentBeatType": null, "alignedBlockIds": null, "matchConfidence": 0.8 } ], "loops": [], "locked": true }, { "page": 7, "type": "tension", "title": "The slide uses a direct quote to frame TransMedics as a failing company due to poor leadership and predatory behavior, drawing an analogy to Blackberry's declin", "function": "expose_contradiction", "rawType": "testimonial", "block": null, "metadata": { "slideType": "testimonial", "slideTypeCanon": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52d-0a2d-7782-8a48-7e84df92cc97", "version": 1, "description": null }, "function": "expose_contradiction", "functionCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-171f-776f-887c-73edaff4cf9c", "version": 1, "description": null }, "density": "balanced", "densityScore": 36, "componentCount": 3, "textChars": 1684, "nDataPoints": 0, "notes": "The slide uses a direct quote to frame TransMedics as a failing company due to poor leadership and predatory behavior, drawing an analogy to Blackberry's decline.", "elementsJson": [ "quote_block" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 21:25:48.064+00", "seconds": 4.607, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/7", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-7", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "TransMedics is going to die because people are so pissed off with the company and this predatory behavior.", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-23 01:18:10+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-70f3-714d-84be-a593143b48c4", "parentComponentId": null }, { "bbox": { "h": 0.34, "w": 0.7, "x": 0.15, "y": 0.33 }, "kind": "quote", "text": "“This is my take-home message to you - that this is just a matter of time. Back in the ‘90s Blackberry dominated. Now it’s history. TransMedics is going to be like Blackberry. TransMedics is going to die because people are so pissed off with the company and this predatory behavior. People are just going to quit using it. They’re very upset, and it’s going to be, “Screw you, I don’t want to use this product anymore.” People are not happy with the management of the company. Everybody hates the CEO, the CFO, and all the people in the upper level...it’s run by the wrong people...doctors are going to run from this company.” – Transplant surgeon in a leadership role at Vanderbilt, one of the top centers in the US, which has already wiped out TransMedics usage in heart, lung, and liver", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:25:48.064+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "f28c1949-1ae4-4273-9998-eaefc2be22fc", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "“This is my take-home message to you - that this is just a matter of time. Back in the '90s Blackberry dominated. Now it's history. TransMedics is going to be like Blackberry. TransMedics is going to die because people are so pissed off with the company and this predatory behavior. People are just going to quit using it. They're very upset, and it's going to be, “Screw you, I don't want to use this product anymore.” People are not happy with the management of the company. Everybody hates the CEO, the CFO, and all the people in the upper level...it's run by the wrong people...doctors are going to run from this company.” — Transplant surgeon in a leadership role at Vanderbilt, one of the top centers in the US, which has already wiped out TransMedics usage in heart, lung, and liver", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-23 01:18:10+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-70f3-714d-84be-a839a3d2bf9a", "parentComponentId": null } ], "metrics": [], "tools": [ { "tool": { "name": "Villain slide", "slug": "villain-slide", "status": "active", "bestFor": "In activist decks where the personality matters", "canonId": "019dd9e1-518c-7404-976a-5be5a517b659", "version": 1, "bodyDocId": null, "description": "A dedicated slide presenting the named villain visually", "familyLabel": null, "categoryName": null, "categorySlug": null }, "agent": null, "layer": "slide", "agents": null, "matchId": "b673fb97-0720-4a72-94f7-1cae8c3b372f", "evidence": "The slide explicitly states 'TransMedics is going to die', which could be seen as a strong negative statement typical of a villain slide.", "pageRefs": null, "priority": null, "whenToUse": "In activist decks where the personality matters", "confidence": 0.8, "extraction": { "at": "2026-07-16 23:10:25.660092+00", "model": "or:meta-llama/llama-4-scout", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 7, "whyItWorks": "Makes the antagonist concrete", "antipattern": null, "cardinality": null, "narrativePurpose": null } ], "frameworks": [ { "matchId": "a9072226-f23f-44e3-ad9e-2389a7bbd0a2", "evidence": "Comparison of TransMedics to Blackberry's decline.", "framework": null, "confidence": 0.9, "extraction": { "at": "2026-05-02 21:25:48.064+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 7, "frameworkName": "argument-from-analogy" } ], "arcBeats": [ { "to": 9, "arc": { "name": "Overcoming the Monster", "slug": "overcoming-monster", "status": "active", "bestFor": "Competitive positioning, rallying teams", "canonId": "019dd956-6339-76ac-9cbf-4b377c3aa89e", "version": 1, "bodyDocId": "019df22a-2356-73eb-8061-d8c81dc0aa49", "structure": "The Monster -> The Call -> The Struggle -> The Victory -> The New Order", "description": null, "familyLabel": null }, "from": 3, "name": "Testimonials from Industry Experts", "beatId": "2ce2729c-3fa0-4258-b23a-c05ff53032bc", "matchId": "d22e2123-5207-45f3-8f91-8fe159736ca7", "beatType": null, "evidence": "The section presents testimonials from experts and industry professionals criticizing TransMedics Group Inc.", "position": 2, "isPrimaryArc": true, "parentBeatType": null, "alignedBlockIds": null, "matchConfidence": 0.8 } ], "loops": [], "locked": true }, { "page": 8, "type": "setup", "title": "The slide uses highly aggressive, accusatory language (e.g., 'fraudulent billing racket', 'organ trafficking scheme', 'prostitutes').", "function": "front_matter", "rawType": "table_of_contents", "block": null, "metadata": { "slideType": "table_of_contents", "slideTypeCanon": { "name": "Table of contents", "slug": "table_of_contents", "status": "active", "canonId": "019de52d-0643-721b-9b85-69676bb85cf8", "version": 1, "description": null }, "function": "front_matter", "functionCanon": { "name": "Front matter", "slug": "front_matter", "status": "active", "canonId": "019de52d-133d-73f0-9e26-201eda96b098", "version": 1, "description": null }, "density": "dense", "densityScore": 71, "componentCount": 9, "textChars": 1601, "nDataPoints": 0, "notes": "The slide uses highly aggressive, accusatory language (e.g., 'fraudulent billing racket', 'organ trafficking scheme', 'prostitutes').", "elementsJson": [ "paragraph" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 21:25:47.206+00", "seconds": 3.626, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/8", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-8", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": { "h": 0.08, "w": 0.86, "x": 0.07, "y": 0.13 }, "kind": "list", "text": "Introduction to the real TransMedics: a 6-month investigation with over 30 interviews, including ex-employees, surgeons, leading transplant centers, organ procurement organizations, competitors, and its largest customers. 11", "attrs": null, "canon": { "kind": { "name": "List", "slug": "list", "status": "active", "canonId": "019de52c-f94b-779b-a53b-fd4904a5f4d2", "version": 1, "description": "Bullet or numbered list." }, "tool": null, "subkind": { "name": "Bullet list", "slug": "bullet", "status": "active", "canonId": "019de52c-fc98-7169-a083-5cab805076ca", "version": 1, "description": null }, "framework": null }, "subkind": "bullet", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:25:47.206+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "40a86900-0d89-4e7b-bbcb-8fe0004b2270", "parentComponentId": null }, { "bbox": { "h": 0.07, "w": 0.86, "x": 0.07, "y": 0.71 }, "kind": "list", "text": "Part 5. We believe TransMedics is operating an organ trafficking scheme, shopping and steering rejected organs to its top users as a quid pro quo for accepting them on its device and via its NOP service. 124", "attrs": null, "canon": { "kind": { "name": "List", "slug": "list", "status": "active", "canonId": "019de52c-f94b-779b-a53b-fd4904a5f4d2", "version": 1, "description": "Bullet or numbered list." }, "tool": null, "subkind": { "name": "Bullet list", "slug": "bullet", "status": "active", "canonId": "019de52c-fc98-7169-a083-5cab805076ca", "version": 1, "description": null }, "framework": null }, "subkind": "bullet", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:25:47.206+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "43d030d9-e0d4-47ee-8538-0b3f4451c6b4", "parentComponentId": null }, { "bbox": { "h": 0.07, "w": 0.86, "x": 0.07, "y": 0.47 }, "kind": "list", "text": "Part 3. Revenue is dependent on a handful of transplant surgeons/centers - \"prostitutes\" who are \"completely owned and operated by TransMedics\" - who allegedly receive kickbacks and inducements. 98", "attrs": null, "canon": { "kind": { "name": "List", "slug": "list", "status": "active", "canonId": "019de52c-f94b-779b-a53b-fd4904a5f4d2", "version": 1, "description": "Bullet or numbered list." }, "tool": null, "subkind": { "name": "Bullet list", "slug": "bullet", "status": "active", "canonId": "019de52c-fc98-7169-a083-5cab805076ca", "version": 1, "description": null }, "framework": null }, "subkind": "bullet", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:25:47.206+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "5a2919ab-44ce-440e-9abf-bd67bd0474c6", "parentComponentId": null }, { "bbox": { "h": 0.07, "w": 0.86, "x": 0.07, "y": 0.59 }, "kind": "list", "text": "Part 4. These high-volume users may allegedly be under scrutiny as part of multiple investigations by federal and states authorities and agencies, as well as by prominent news outlets, indicating the precarious nature of TransMedics business. 109", "attrs": null, "canon": { "kind": { "name": "List", "slug": "list", "status": "active", "canonId": "019de52c-f94b-779b-a53b-fd4904a5f4d2", "version": 1, "description": "Bullet or numbered list." }, "tool": null, "subkind": { "name": "Bullet list", "slug": "bullet", "status": "active", "canonId": "019de52c-fc98-7169-a083-5cab805076ca", "version": 1, "description": null }, "framework": null }, "subkind": "bullet", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:25:47.206+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "6d3589c2-5188-4943-96cf-b55d330f1225", "parentComponentId": null }, { "bbox": { "h": 0.08, "w": 0.86, "x": 0.07, "y": 0.83 }, "kind": "list", "text": "Part 6. TransMedics device usage is, we conclude, almost all off-label, the largest such racket we have encountered, putting it at existential risk: \"I've never seen a device manufacturer so boldly engage in off-label use themselves...it's their technician.\" 154", "attrs": null, "canon": { "kind": { "name": "List", "slug": "list", "status": "active", "canonId": "019de52c-f94b-779b-a53b-fd4904a5f4d2", "version": 1, "description": "Bullet or numbered list." }, "tool": null, "subkind": { "name": "Bullet list", "slug": "bullet", "status": "active", "canonId": "019de52c-fc98-7169-a083-5cab805076ca", "version": 1, "description": null }, "framework": null }, "subkind": "bullet", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:25:47.206+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "960e94a6-e4ae-4f4c-98a4-6235c16c0747", "parentComponentId": null }, { "bbox": { "h": 0.05, "w": 0.86, "x": 0.07, "y": 0.37 }, "kind": "list", "text": "Part 2. The NOP service is, in our opinion, a large-scale fraudulent billing racket, predicated on overcharging hospitals for unnecessary flights. 70", "attrs": null, "canon": { "kind": { "name": "List", "slug": "list", "status": "active", "canonId": "019de52c-f94b-779b-a53b-fd4904a5f4d2", "version": 1, "description": "Bullet or numbered list." }, "tool": null, "subkind": { "name": "Bullet list", "slug": "bullet", "status": "active", "canonId": "019de52c-fc98-7169-a083-5cab805076ca", "version": 1, "description": null }, "framework": null }, "subkind": "bullet", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:25:47.206+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "c5f4acf7-0369-46c2-ac2a-e2857fcec573", "parentComponentId": null }, { "bbox": { "h": 0.07, "w": 0.86, "x": 0.07, "y": 0.25 }, "kind": "list", "text": "Part 1. TransMedics National OCS Program (NOP): an unsustainable, anti-competitive scheme based on what we believe to be coercive tying, price extortion, and retaliation. 41", "attrs": null, "canon": { "kind": { "name": "List", "slug": "list", "status": "active", "canonId": "019de52c-f94b-779b-a53b-fd4904a5f4d2", "version": 1, "description": "Bullet or numbered list." }, "tool": null, "subkind": { "name": "Bullet list", "slug": "bullet", "status": "active", "canonId": "019de52c-fc98-7169-a083-5cab805076ca", "version": 1, "description": null }, "framework": null }, "subkind": "bullet", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:25:47.206+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "f84a15b8-b985-41dd-91bb-b4691a97ae8e", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "“I’ve never seen a device manufacturer so boldly engage in off-label use themselves...it’s their technician.” — Unnamed source", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:45:58+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a974-3bbd2248f59e", "parentComponentId": null }, { "bbox": { "h": 0.04, "w": 0.25, "x": 0.07, "y": 0.07 }, "kind": "title", "text": "Table of contents", "attrs": null, "canon": { "kind": { "name": "Title", "slug": "title", "status": "active", "canonId": "019de52c-f7dd-76d9-b848-b1f12bd85cf4", "version": 1, "description": "Slide title or headline." }, "tool": null, "subkind": { "name": "Headline", "slug": "headline", "status": "active", "canonId": "019de52c-fae1-7463-9a7c-d60668eced0d", "version": 1, "description": null }, "framework": null }, "subkind": "headline", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:25:47.206+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "62ebc7ae-3b40-4dba-a7b3-2b847c33264e", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [], "arcBeats": [ { "to": 9, "arc": { "name": "Overcoming the Monster", "slug": "overcoming-monster", "status": "active", "bestFor": "Competitive positioning, rallying teams", "canonId": "019dd956-6339-76ac-9cbf-4b377c3aa89e", "version": 1, "bodyDocId": "019df22a-2356-73eb-8061-d8c81dc0aa49", "structure": "The Monster -> The Call -> The Struggle -> The Victory -> The New Order", "description": null, "familyLabel": null }, "from": 3, "name": "Testimonials from Industry Experts", "beatId": "2ce2729c-3fa0-4258-b23a-c05ff53032bc", "matchId": "d22e2123-5207-45f3-8f91-8fe159736ca7", "beatType": null, "evidence": "The section presents testimonials from experts and industry professionals criticizing TransMedics Group Inc.", "position": 2, "isPrimaryArc": true, "parentBeatType": null, "alignedBlockIds": null, "matchConfidence": 0.8 } ], "loops": [], "locked": true }, { "page": 9, "type": "setup", "function": "front_matter", "rawType": "table_of_contents", "block": null, "metadata": { "slideType": "table_of_contents", "slideTypeCanon": { "name": "Table of contents", "slug": "table_of_contents", "status": "active", "canonId": "019de52d-0643-721b-9b85-69676bb85cf8", "version": 1, "description": null }, "function": "front_matter", "functionCanon": { "name": "Front matter", "slug": "front_matter", "status": "active", "canonId": "019de52d-133d-73f0-9e26-201eda96b098", "version": 1, "description": null }, "density": "balanced", "densityScore": 32, "componentCount": 2, "textChars": 1548, "nDataPoints": 0, "notes": null, "elementsJson": [ "data_table" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 21:25:46.36+00", "seconds": 2.536, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/9", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-9", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": { "h": 0.75, "w": 0.86, "x": 0.07, "y": 0.13 }, "kind": "list", "text": "Part 7. The NOP organ procurement service is “a ticking time bomb” staffed with imported H1B surgeons unlicensed to practice medicine in the US, from high-risk areas like India, Pakistan, and the Middle East; resulting in butchered and lost organs. 193\nPart 8. The NOP service, we believe, traffics in and pushes unsafe, damaged organs rejected by reputable centers, as an unplaced organ means loss of device and aircraft fees; with TransMedics allegedly concealing adverse organ information. 227\nPart 9. Organs on TransMedics devices are managed by inexperienced, high-risk technicians called OCS Specialists, who allegedly receive only a week of training prior to engaging in the practice of medicine, putting organs and recipients in jeopardy. 240\nPart 10. Customer rage: TransMedics business practices have antagonized the small world of transplant, past the point of no return – a short-tempered CEO; allegedly threatening centers who state that organs have been held hostage from ill patients. 249\nPart 11. An accelerating customer exodus, the fastest such stampede we have ever encountered. Large, pre-eminent transplant centers have eliminated or sharply reduced usage; its remaining high-volume customers indicate they are in the process of doing so. 269\nPart 12. TransMedics device has no value proposition. Even its largest customers admit it has no clinical benefit to organs, using it off-label strictly for “surgeon lifestyle” and scheduling convenience; or, we believe, in exchange for organs steered improperly. 281", "attrs": null, "canon": { "kind": { "name": "List", "slug": "list", "status": "active", "canonId": "019de52c-f94b-779b-a53b-fd4904a5f4d2", "version": 1, "description": "Bullet or numbered list." }, "tool": null, "subkind": { "name": "Numbered list", "slug": "numbered", "status": "active", "canonId": "019de52c-fcc0-7718-a284-a4250c805df2", "version": 1, "description": null }, "framework": null }, "subkind": "numbered", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:25:46.36+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "3719342a-f0fe-4ae0-b9ce-f84e1c9a2666", "parentComponentId": null }, { "bbox": { "h": 0.03, "w": 0.25, "x": 0.07, "y": 0.07 }, "kind": "title", "text": "Table of contents", "attrs": null, "canon": { "kind": { "name": "Title", "slug": "title", "status": "active", "canonId": "019de52c-f7dd-76d9-b848-b1f12bd85cf4", "version": 1, "description": "Slide title or headline." }, "tool": null, "subkind": { "name": "Headline", "slug": "headline", "status": "active", "canonId": "019de52c-fae1-7463-9a7c-d60668eced0d", "version": 1, "description": null }, "framework": null }, "subkind": "headline", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:25:46.36+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "72eff32c-2e32-4a81-9a63-19169dcf25c6", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [], "arcBeats": [ { "to": 9, "arc": { "name": "Overcoming the Monster", "slug": "overcoming-monster", "status": "active", "bestFor": "Competitive positioning, rallying teams", "canonId": "019dd956-6339-76ac-9cbf-4b377c3aa89e", "version": 1, "bodyDocId": "019df22a-2356-73eb-8061-d8c81dc0aa49", "structure": "The Monster -> The Call -> The Struggle -> The Victory -> The New Order", "description": null, "familyLabel": null }, "from": 3, "name": "Testimonials from Industry Experts", "beatId": "2ce2729c-3fa0-4258-b23a-c05ff53032bc", "matchId": "d22e2123-5207-45f3-8f91-8fe159736ca7", "beatType": null, "evidence": "The section presents testimonials from experts and industry professionals criticizing TransMedics Group Inc.", "position": 2, "isPrimaryArc": true, "parentBeatType": null, "alignedBlockIds": null, "matchConfidence": 0.8 } ], "loops": [], "locked": true }, { "page": 10, "type": "setup", "function": "front_matter", "rawType": "table_of_contents", "block": null, "metadata": { "slideType": "table_of_contents", "slideTypeCanon": { "name": "Table of contents", "slug": "table_of_contents", "status": "active", "canonId": "019de52d-0643-721b-9b85-69676bb85cf8", "version": 1, "description": null }, "function": "front_matter", "functionCanon": { "name": "Front matter", "slug": "front_matter", "status": "active", "canonId": "019de52d-133d-73f0-9e26-201eda96b098", "version": 1, "description": null }, "density": "sparse", "densityScore": 17, "componentCount": 2, "textChars": 796, "nDataPoints": 0, "notes": null, "elementsJson": [ "headline_text", "numbered_list" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 21:25:46.036+00", "seconds": 1.992, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/10", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-10", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": { "h": 0.45, "w": 0.86, "x": 0.07, "y": 0.13 }, "kind": "list", "text": "Part 13. Competitive tsunami. TransMedics is being rapidly replaced by superior devices at a fraction of the cost, which began rolling out only recently. Customer interviews indicate delivery of OrganOx, Paragonix, and other devices at a weekly clip. 303\nPart 14. Disruption by NRP, spreading like wildfire. OPO's and transplant centers are standardizing around an inexpensive, alternative technique which has long been the standard of care in Europe, with TransMedics 2025 revenue at risk of collapse. 317\nPart 15. TransMedics device is at risk of recall, plagued by what we think is a high failure rate, resulting in necrotic livers with dead tissue and other issues. Surgeons report losing a significant percentage of organs, and allege a cover-up by dishonest management. 326", "attrs": null, "canon": { "kind": { "name": "List", "slug": "list", "status": "active", "canonId": "019de52c-f94b-779b-a53b-fd4904a5f4d2", "version": 1, "description": "Bullet or numbered list." }, "tool": null, "subkind": { "name": "Numbered list", "slug": "numbered", "status": "active", "canonId": "019de52c-fcc0-7718-a284-a4250c805df2", "version": 1, "description": null }, "framework": null }, "subkind": "numbered", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:25:46.036+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "ec7c36fd-c34a-41dd-9451-e4ff37306769", "parentComponentId": null }, { "bbox": { "h": 0.04, "w": 0.25, "x": 0.07, "y": 0.07 }, "kind": "title", "text": "Table of contents", "attrs": null, "canon": { "kind": { "name": "Title", "slug": "title", "status": "active", "canonId": "019de52c-f7dd-76d9-b848-b1f12bd85cf4", "version": 1, "description": "Slide title or headline." }, "tool": null, "subkind": { "name": "Headline", "slug": "headline", "status": "active", "canonId": "019de52c-fae1-7463-9a7c-d60668eced0d", "version": 1, "description": null }, "framework": null }, "subkind": "headline", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:25:46.036+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "ede555dd-47b5-4518-b6ea-9c7d2f8756c6", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [], "arcBeats": [], "loops": [], "locked": true }, { "page": 11, "type": "tension", "title": "The slide uses extreme, inflammatory language to attack the subject company and its leadership.", "function": "name_villain", "rawType": "villain_critique", "block": null, "metadata": { "slideType": "villain_critique", "slideTypeCanon": { "name": "Villain critique", "slug": "villain_critique", "status": "active", "canonId": "019de52d-10bc-7136-bf20-09de59d17447", "version": 1, "description": null }, "function": "name_villain", "functionCanon": { "name": "Name villain", "slug": "name_villain", "status": "active", "canonId": "019de52d-1746-70d6-bc58-5eeaf5865526", "version": 1, "description": null }, "density": "sparse", "densityScore": 15, "componentCount": 4, "textChars": 430, "nDataPoints": 0, "notes": "The slide uses extreme, inflammatory language to attack the subject company and its leadership.", "elementsJson": [ "paragraph", "headshot", "screenshot", "footnote" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 21:25:46.492+00", "seconds": 2.327, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/11", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-11", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "It is more accurately a racket, the closest we’ve seen in the public markets to a Mafia-style extortion scheme.", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:04+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a976-b921f6365cb9", "parentComponentId": null }, { "bbox": { "h": 0.31, "w": 0.52, "x": 0.07, "y": 0.61 }, "kind": "image", "text": "Video screenshot of TransMedics CEO Waleed Hassanein", "attrs": null, "canon": { "kind": { "name": "Image", "slug": "image", "status": "active", "canonId": "019de52c-f978-701f-a720-51d029d769e7", "version": 1, "description": "Photo, illustration, screenshot or icon." }, "tool": null, "subkind": { "name": "Screenshot", "slug": "screenshot", "status": "active", "canonId": "019de52c-fd87-7509-8391-3d79fb339379", "version": 1, "description": null }, "framework": null }, "subkind": "screenshot", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:25:46.492+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "bf171eed-75d7-4bad-95d2-76845f0cb3af", "parentComponentId": null }, { "bbox": { "h": 0.55, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "paragraph", "text": "In 20 years of shorting, TransMedics is the most extreme and grotesque healthcare fraud we have encountered, not only for its scale, but because it is predicated on the exploitation of the most vulnerable patients...", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:25:46.492+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "f8fe21f1-2c0c-4f83-bea8-a06cc2226910", "parentComponentId": null }, { "bbox": { "h": 0.02, "w": 0.25, "x": 0.07, "y": 0.96 }, "kind": "source-note", "text": "Source: https://www.youtube.com/watch?v=mmadFropCpc", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:25:46.492+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "b8398a77-6588-4679-b6a0-822f9c4146c3", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [ { "matchId": "f29923a4-99b4-4e9d-bfae-57a354b9e78d", "evidence": "The slide explicitly frames the CEO and company as a 'mafia-style' villain.", "framework": null, "confidence": 0.9, "extraction": { "at": "2026-05-02 21:25:46.492+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 11, "frameworkName": "antagonist-introduction" } ], "arcBeats": [ { "to": 20, "arc": { "name": "Overcoming the Monster", "slug": "overcoming-monster", "status": "active", "bestFor": "Competitive positioning, rallying teams", "canonId": "019dd956-6339-76ac-9cbf-4b377c3aa89e", "version": 1, "bodyDocId": "019df22a-2356-73eb-8061-d8c81dc0aa49", "structure": "The Monster -> The Call -> The Struggle -> The Victory -> The New Order", "description": null, "familyLabel": null }, "from": 11, "name": "Critique of TransMedics Group Inc.", "beatId": "c9fa8ec4-9e59-45eb-9317-74367547147c", "matchId": "d22e2123-5207-45f3-8f91-8fe159736ca7", "beatType": null, "evidence": "The section presents a critical analysis of TransMedics Group Inc.'s practices and leadership.", "position": 0, "isPrimaryArc": true, "parentBeatType": null, "alignedBlockIds": null, "matchConfidence": 0.8 } ], "loops": [], "locked": true }, { "page": 12, "type": "tension", "title": "The slide uses a 'Spy The Lie' framework to interpret CEO responses as deceptive.", "function": "expose_contradiction", "rawType": "expose_contradiction", "block": null, "metadata": { "slideType": "expose_contradiction", "slideTypeCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-124c-75aa-984a-0a3d0d8fc8df", "version": 1, "description": null }, "function": "expose_contradiction", "functionCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-171f-776f-887c-73edaff4cf9c", "version": 1, "description": null }, "density": "dense", "densityScore": 71, "componentCount": 8, "textChars": 3063, "nDataPoints": 0, "notes": "The slide uses a 'Spy The Lie' framework to interpret CEO responses as deceptive.", "elementsJson": [ "paragraph", "quote_block", "footnote" ], "confidence": 0.95, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 21:25:47.831+00", "seconds": 3.495, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/12", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-12", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "Two of the highest-risk behaviors, unsurprisingly, are denial and attack.", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-23 01:18:10+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-70f3-714d-84be-b6dd3366fdd1", "parentComponentId": null }, { "bbox": { "h": 0.4, "w": 0.86, "x": 0.07, "y": 0.52 }, "kind": "list", "text": "“...there is no shift in gears. It’s your perception of reality.”\n“I caution the Street from trying to create something out of nothing.”\n“There’s absolutely, categorically no impact of any technologies, methodologies, or competitive dynamics on the decline in Q3...the facts are the facts.”\n“I want to make it crystal clear. We have not seen any fundamental or competitive dynamics... Let me repeat it again, there has not been or we have not seen any fundamental or competitive dynamics...”\n“Guys, I want to be crystal clear...abdominal NRP does not impact OCS.”\n“There is no clear reason for these declines other than normal variability.”\n“Listen, we’re just coming out of a quarter where transplant volumes declined...”\n“I repeat again, our share in heart and liver...remain unchanged.”", "attrs": null, "canon": { "kind": { "name": "List", "slug": "list", "status": "active", "canonId": "019de52c-f94b-779b-a53b-fd4904a5f4d2", "version": 1, "description": "Bullet or numbered list." }, "tool": null, "subkind": { "name": "Bullet list", "slug": "bullet", "status": "active", "canonId": "019de52c-fc98-7169-a083-5cab805076ca", "version": 1, "description": null }, "framework": null }, "subkind": "bullet", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:25:47.831+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "aab16274-d3c7-4503-8957-bd4187db801f", "parentComponentId": null }, { "bbox": { "h": 0.12, "w": 0.86, "x": 0.07, "y": 0.34 }, "kind": "paragraph", "text": "The OPCO analyst asked a question on the Q3 call, and we note the CEO’s replies below: “So Waleed, I’d be remiss...quite a shock...trying to connect all your comments together, I confess I’m still struggling to understand...I’m curious, there seems to have been a break in your trajectory of share gain....”", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:25:47.831+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "b2f66830-d7c5-4064-8c26-e19db8beba5f", "parentComponentId": null }, { "bbox": { "h": 0.12, "w": 0.86, "x": 0.07, "y": 0.22 }, "kind": "paragraph", "text": "As short-sellers, we are partial to books like Spy The Lie, by ex-CIA interrogators on spotting deception. Skim it on your Kindle en route to JPM, if you have a 1x1 next week with TransMedics. Two of the highest-risk behaviors, unsurprisingly, are denial and attack.", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:25:47.831+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "d267c89d-3458-48f4-a960-d11c2bbca83c", "parentComponentId": null }, { "bbox": { "h": 0.15, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "paragraph", "text": "Investors sense something is afoot, after a spate of recent bad news: a Q3 miss and startling drop in sequential revenue; the CFO fired a month later, after a 10-year tenure; a disastrous Dec investor day and 2025 guide – back-half weighted, naturally.", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:25:47.831+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "fb57eba7-3483-465f-b100-65df4bb0c9c6", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "“So Waleed, I’d be remiss...quite a shock...trying to connect all your comments together, I confess I’m still struggling to understand...I’m curious, there seems to have been a break in your trajectory of share gain....” — OPCO Analyst; “...there is no shift in gears. It’s your perception of reality.” — CEO Waleed Hassanein; “I caution the Street from trying to create something out of nothing.” — CEO Waleed Hassanein; “There’s absolutely, categorically no impact of any technologies, methodologies, or competitive dynamics on the decline in Q3...the facts are the facts.” — CEO Waleed Hassanein; “I want to make it crystal clear. We have not seen any fundamental or competitive dynamics... Let me repeat it again, there has not been or we have not seen any fundamental or competitive dynamics...” — CEO Waleed Hassanein; “Guys, I want to be crystal clear...abdominal NRP does not impact OCS.” — CEO Waleed Hassanein; “There is no clear reason for these declines other than normal variability.” — CEO Waleed Hassanein; “Listen, we’re just coming out of a quarter where transplant volumes declined...” — CEO Waleed Hassanein; “I repeat again, our share in heart and liver...remain unchanged.” — CEO Waleed Hassanein", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-23 01:18:10+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-70f3-714d-84be-bb6ce54e721f", "parentComponentId": null }, { "bbox": { "h": 0.02, "w": 0.4, "x": 0.07, "y": 0.96 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts; Capital IQ earnings call transcripts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:25:47.831+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "bff5ee38-d824-4379-a892-b4363ab0028a", "parentComponentId": null }, { "bbox": { "h": 0.03, "w": 0.5, "x": 0.07, "y": 0.48 }, "kind": "title", "text": "TransMedics Q3 earnings call, Oct 28, 2024 – CEO Waleed Hassanein", "attrs": null, "canon": { "kind": { "name": "Title", "slug": "title", "status": "active", "canonId": "019de52c-f7dd-76d9-b848-b1f12bd85cf4", "version": 1, "description": "Slide title or headline." }, "tool": null, "subkind": { "name": "Subtitle", "slug": "subtitle", "status": "active", "canonId": "019de52c-fb09-739d-900c-815b0d9ac526", "version": 1, "description": null }, "framework": null }, "subkind": "subtitle", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:25:47.831+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "ae2bb926-dc0c-47e8-86fb-00e12ba59cbe", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [ { "matchId": "15973f97-4960-4431-a5ac-bd094bdfd287", "evidence": "Framing the CEO's responses as 'denial and attack' based on 'Spy The Lie' methodology.", "framework": null, "confidence": 0.85, "extraction": { "at": "2026-05-02 21:25:47.831+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 12, "frameworkName": "antagonist-introduction" } ], "arcBeats": [ { "to": 20, "arc": { "name": "Overcoming the Monster", "slug": "overcoming-monster", "status": "active", "bestFor": "Competitive positioning, rallying teams", "canonId": "019dd956-6339-76ac-9cbf-4b377c3aa89e", "version": 1, "bodyDocId": "019df22a-2356-73eb-8061-d8c81dc0aa49", "structure": "The Monster -> The Call -> The Struggle -> The Victory -> The New Order", "description": null, "familyLabel": null }, "from": 11, "name": "Critique of TransMedics Group Inc.", "beatId": "c9fa8ec4-9e59-45eb-9317-74367547147c", "matchId": "d22e2123-5207-45f3-8f91-8fe159736ca7", "beatType": null, "evidence": "The section presents a critical analysis of TransMedics Group Inc.'s practices and leadership.", "position": 0, "isPrimaryArc": true, "parentBeatType": null, "alignedBlockIds": null, "matchConfidence": 0.8 }, { "to": 30, "arc": { "name": "Overcoming the Monster", "slug": "overcoming-monster", "status": "active", "bestFor": "Competitive positioning, rallying teams", "canonId": "019dd956-6339-76ac-9cbf-4b377c3aa89e", "version": 1, "bodyDocId": "019df22a-2356-73eb-8061-d8c81dc0aa49", "structure": "The Monster -> The Call -> The Struggle -> The Victory -> The New Order", "description": null, "familyLabel": null }, "from": 12, "name": "Exposure of Contradictions", "beatId": "072007ec-5fd3-4416-b852-0e181a364efd", "matchId": "d22e2123-5207-45f3-8f91-8fe159736ca7", "beatType": null, "evidence": "The section highlights contradictions in TransMedics Group Inc.'s statements and actions.", "position": 1, "isPrimaryArc": true, "parentBeatType": null, "alignedBlockIds": null, "matchConfidence": 0.8 } ], "loops": [], "locked": true }, { "page": 13, "type": "tension", "title": "The slide uses aggressive, accusatory language ('fraud', 'hubris', 'one-trick pony') to frame the company negatively.", "function": "name_villain", "rawType": "villain_critique", "block": null, "metadata": { "slideType": "villain_critique", "slideTypeCanon": { "name": "Villain critique", "slug": "villain_critique", "status": "active", "canonId": "019de52d-10bc-7136-bf20-09de59d17447", "version": 1, "description": null }, "function": "name_villain", "functionCanon": { "name": "Name villain", "slug": "name_villain", "status": "active", "canonId": "019de52d-1746-70d6-bc58-5eeaf5865526", "version": 1, "description": null }, "density": "dense", "densityScore": 57, "componentCount": 6, "textChars": 1629, "nDataPoints": 80, "notes": "The slide uses aggressive, accusatory language ('fraud', 'hubris', 'one-trick pony') to frame the company negatively.", "elementsJson": [ "paragraph", "data_table" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 21:25:49.821+00", "seconds": 5.351, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/13", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-13", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "The company’s disclosure is opaque, as it fails to break out the key figure – device sales by organ – showing only a product/service total by SKU.", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:45:51+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5372-7340-8f99-4210e443b310", "parentComponentId": null }, { "bbox": null, "kind": "metric", "text": "Revenue", "attrs": null, "canon": { "kind": { "name": "Metric", "slug": "metric", "status": "active", "canonId": "019de52c-f923-73bf-8081-d0b1a8c5264d", "version": 1, "description": "Big-number or KPI value." }, "tool": { "name": "Quantification", "slug": "quantification", "status": "active", "bestFor": null, "canonId": "019dd9e1-47ab-72ce-a079-aab1f5299e88", "version": 1, "bodyDocId": null, "description": "Translating a claim into numbers, charts, or tables.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": "primary", "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:45:51+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5372-7340-8f99-458912c41c9d", "parentComponentId": null }, { "bbox": { "h": 0.65, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "paragraph", "text": "If you own the stock, we have bad news for you: it’s already over. You just don’t know it yet. Fasten your seatbelt and put on some goggles, because the stuff has yet to hit the fan. The TransMedics story is cliche for a fraud - hubris, overreach, calling to mind the usual genre, Icarus, Narcissus, or perhaps for this one, Shelley’s ode to the pharaoh Ozymandias. TransMedics has an unusual and cunning business model, a creature of perverse incentives unique to organ transplantation. It sells a device for the transportation, preservation, and assessment of organs for transplant, called the Organ Care System (OCS) – plus an outsourced end-to-end service called the National OCS Program (NOP), comprised of its own fleet of private jets, organ procurement surgeons, and device technicians who manage the organ. The device comes in three versions for lung, heart, and liver. NOP service revenue comprised 39% in the last quarter; and the company is a one-trick pony for liver. Lung, its first product, is a self-evident failure. Heart growth has been underwhelming, and all three versions declined sequentially in the last quarter. The company’s disclosure is opaque, as it fails to break out the key figure – device sales by organ – showing only a product/service total by SKU.", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:25:49.821+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "4a0e6216-a799-4967-8838-a9debf9f7efe", "parentComponentId": null }, { "bbox": { "h": 0.03, "w": 0.67, "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts; Capital IQ data; TransMedics SEC filings; Scorpion Capital estimates and analysis", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:25:49.821+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "c84664f7-271b-4b13-b90a-c14a7de82927", "parentComponentId": null }, { "bbox": { "h": 0.18, "w": 0.43, "x": 0.07, "y": 0.73 }, "kind": "table", "text": "Product vs. service revenue table", "attrs": null, "canon": { "kind": { "name": "Table", "slug": "table", "status": "active", "canonId": "019de52c-f9c8-7148-8119-eaac9594cd28", "version": 1, "description": "Tabular data layout." }, "tool": null, "subkind": { "name": "Data table", "slug": "data", "status": "active", "canonId": "019de52d-02d5-75b8-8abf-88e92bf63569", "version": 1, "description": null }, "framework": null }, "subkind": "data", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:25:49.821+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "aefd84cc-672a-41a6-ba6c-eca8e1176ca8", "parentComponentId": null }, { "bbox": { "h": 0.18, "w": 0.42, "x": 0.51, "y": 0.73 }, "kind": "table", "text": "Revenue by organ table", "attrs": null, "canon": { "kind": { "name": "Table", "slug": "table", "status": "active", "canonId": "019de52c-f9c8-7148-8119-eaac9594cd28", "version": 1, "description": "Tabular data layout." }, "tool": null, "subkind": { "name": "Data table", "slug": "data", "status": "active", "canonId": "019de52d-02d5-75b8-8abf-88e92bf63569", "version": 1, "description": null }, "framework": null }, "subkind": "data", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:25:49.821+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "eb6e897a-6158-4f14-a42f-c7d5d93f5f96", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [], "arcBeats": [ { "to": 20, "arc": { "name": "Overcoming the Monster", "slug": "overcoming-monster", "status": "active", "bestFor": "Competitive positioning, rallying teams", "canonId": "019dd956-6339-76ac-9cbf-4b377c3aa89e", "version": 1, "bodyDocId": "019df22a-2356-73eb-8061-d8c81dc0aa49", "structure": "The Monster -> The Call -> The Struggle -> The Victory -> The New Order", "description": null, "familyLabel": null }, "from": 11, "name": "Critique of TransMedics Group Inc.", "beatId": "c9fa8ec4-9e59-45eb-9317-74367547147c", "matchId": "d22e2123-5207-45f3-8f91-8fe159736ca7", "beatType": null, "evidence": "The section presents a critical analysis of TransMedics Group Inc.'s practices and leadership.", "position": 0, "isPrimaryArc": true, "parentBeatType": null, "alignedBlockIds": null, "matchConfidence": 0.8 }, { "to": 30, "arc": { "name": "Overcoming the Monster", "slug": "overcoming-monster", "status": "active", "bestFor": "Competitive positioning, rallying teams", "canonId": "019dd956-6339-76ac-9cbf-4b377c3aa89e", "version": 1, "bodyDocId": "019df22a-2356-73eb-8061-d8c81dc0aa49", "structure": "The Monster -> The Call -> The Struggle -> The Victory -> The New Order", "description": null, "familyLabel": null }, "from": 12, "name": "Exposure of Contradictions", "beatId": "072007ec-5fd3-4416-b852-0e181a364efd", "matchId": "d22e2123-5207-45f3-8f91-8fe159736ca7", "beatType": null, "evidence": "The section highlights contradictions in TransMedics Group Inc.'s statements and actions.", "position": 1, "isPrimaryArc": true, "parentBeatType": null, "alignedBlockIds": null, "matchConfidence": 0.8 } ], "loops": [], "locked": true }, { "page": 14, "type": "tension", "title": "The slide uses a 'villain' narrative to frame the CEO's actions as potentially criminal, leveraging a recent legal precedent to build credibility.", "function": "expose_contradiction", "rawType": "expose_contradiction", "block": null, "metadata": { "slideType": "expose_contradiction", "slideTypeCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-124c-75aa-984a-0a3d0d8fc8df", "version": 1, "description": null }, "function": "expose_contradiction", "functionCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-171f-776f-887c-73edaff4cf9c", "version": 1, "description": null }, "density": "dense", "densityScore": 68, "componentCount": 8, "textChars": 1631, "nDataPoints": 2, "notes": "The slide uses a 'villain' narrative to frame the CEO's actions as potentially criminal, leveraging a recent legal precedent to build credibility.", "elementsJson": [ "paragraph", "callout_box", "screenshot" ], "confidence": 0.95, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:12:06.591+00", "seconds": 12.994, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/14", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-14", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": { "h": 0.03, "w": 0.5, "x": 0.07, "y": 0.48 }, "kind": "callout", "text": "Press coverage - first conviction for 10b5-1 plan abuses", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": null, "subkind": { "name": "Primary callout", "slug": "primary", "status": "active", "canonId": "019de52c-fbd1-70eb-a9ce-8997f8674c1d", "version": 1, "description": null }, "framework": null }, "subkind": "primary", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:06.591+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "602633ff-7f9f-4da5-9bcd-95f13aec531a", "parentComponentId": null }, { "bbox": null, "kind": "callout", "text": "Stepping outside of a pre-arranged plan is highly unusual and aggressive, especially when the options are not expiring.", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:45:53+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5372-7340-8f99-a4f104e3d48f", "parentComponentId": null }, { "bbox": { "h": 0.08, "w": 0.62, "x": 0.07, "y": 0.72 }, "kind": "legend", "text": "Ex-Ontrak chairman was accused of abusing trading strategy that usually shields executives against suspicions of insider trading", "attrs": null, "canon": { "kind": { "name": "Legend", "slug": "legend", "status": "active", "canonId": "31361933-3d22-4c70-bbad-0801e9fffc0c", "version": 1, "description": "Color/symbol decoder placed adjacent to a chart or diagram." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:06.591+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "31d0aa50-5267-4b02-8c2d-f4dbc2405640", "parentComponentId": null }, { "bbox": { "h": 0.45, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "paragraph", "text": "The sell-side was in “shock” at the Q3 miss – the CEO, perhaps not so much. Despite “absolutely, categorically” asserting nothing was wrong, his trades suggest the opposite. He appears to have been in quite the hurry, stepping outside of his open 10b5-1 plan on 8/21 and 8/22 to monetize 45,000 non-expiring options, generating a net pre-tax profit of $7MM – right in the middle of Q3. He stepped outside of the same plan prior to that in May. Stepping outside of a pre-arranged plan is highly unusual and aggressive, especially when the options are not expiring. It is also high risk. The DOJ recently obtained its first conviction for abuses related to 10b5-1 plans, against an executive accused of misusing his plan and trading based on confidential information.", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:06.591+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "52192f64-638f-432d-935a-2e09e3e84c10", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "Ex-Ontrak chairman was accused of abusing trading strategy that usually shields executives against suspicions of insider trading — WSJ Headline", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:45:53+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5372-7340-8f99-a9beb44af578", "parentComponentId": null }, { "bbox": { "h": 0.05, "w": 0.86, "x": 0.07, "y": 0.92 }, "kind": "source-note", "text": "Source: Scorpion Capital analysis and estimates; TMDX SEC filings; https://www.orrick.com/en/Insights/2023/03/DOJ-Brings-First-Criminal-Charges-for-Trades-Under-a-Rule-10b5-1-Plan; https://www.wsj.com/finance/regulation/jury-convicts-milken-protege-terren-peizer-of-insider-trading-7c78ba2a", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:06.591+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "a7511d66-1983-46f4-b268-1f6e392270bb", "parentComponentId": null }, { "bbox": { "h": 0.08, "w": 0.86, "x": 0.07, "y": 0.52 }, "kind": "title", "text": "DOJ Brings First Criminal Charges for Trades Under a Rule 10b5-1 Plan", "attrs": null, "canon": { "kind": { "name": "Title", "slug": "title", "status": "active", "canonId": "019de52c-f7dd-76d9-b848-b1f12bd85cf4", "version": 1, "description": "Slide title or headline." }, "tool": null, "subkind": { "name": "Headline", "slug": "headline", "status": "active", "canonId": "019de52c-fae1-7463-9a7c-d60668eced0d", "version": 1, "description": null }, "framework": null }, "subkind": "headline", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:06.591+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "c95e0467-0611-4404-8347-df6283d1d843", "parentComponentId": null }, { "bbox": { "h": 0.08, "w": 0.86, "x": 0.07, "y": 0.62 }, "kind": "title", "text": "Jury Convicts Milken Protégé Terren Peizer of Insider Trading", "attrs": null, "canon": { "kind": { "name": "Title", "slug": "title", "status": "active", "canonId": "019de52c-f7dd-76d9-b848-b1f12bd85cf4", "version": 1, "description": "Slide title or headline." }, "tool": null, "subkind": { "name": "Headline", "slug": "headline", "status": "active", "canonId": "019de52c-fae1-7463-9a7c-d60668eced0d", "version": 1, "description": null }, "framework": null }, "subkind": "headline", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:06.591+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "d33b769f-a275-4083-89b8-ad0f97c8f506", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [ { "matchId": "a2014d1f-8b8e-4ee2-a8f3-6ee9ccb0758a", "evidence": "Contrasting CEO public statements with private trading behavior and citing legal precedents.", "framework": null, "confidence": 0.9, "extraction": { "at": "2026-05-02 20:12:06.591+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 14, "frameworkName": "fraud-exposure" } ], "arcBeats": [ { "to": 20, "arc": { "name": "Overcoming the Monster", "slug": "overcoming-monster", "status": "active", "bestFor": "Competitive positioning, rallying teams", "canonId": "019dd956-6339-76ac-9cbf-4b377c3aa89e", "version": 1, "bodyDocId": "019df22a-2356-73eb-8061-d8c81dc0aa49", "structure": "The Monster -> The Call -> The Struggle -> The Victory -> The New Order", "description": null, "familyLabel": null }, "from": 11, "name": "Critique of TransMedics Group Inc.", "beatId": "c9fa8ec4-9e59-45eb-9317-74367547147c", "matchId": "d22e2123-5207-45f3-8f91-8fe159736ca7", "beatType": null, "evidence": "The section presents a critical analysis of TransMedics Group Inc.'s practices and leadership.", "position": 0, "isPrimaryArc": true, "parentBeatType": null, "alignedBlockIds": null, "matchConfidence": 0.8 }, { "to": 30, "arc": { "name": "Overcoming the Monster", "slug": "overcoming-monster", "status": "active", "bestFor": "Competitive positioning, rallying teams", "canonId": "019dd956-6339-76ac-9cbf-4b377c3aa89e", "version": 1, "bodyDocId": "019df22a-2356-73eb-8061-d8c81dc0aa49", "structure": "The Monster -> The Call -> The Struggle -> The Victory -> The New Order", "description": null, "familyLabel": null }, "from": 12, "name": "Exposure of Contradictions", "beatId": "072007ec-5fd3-4416-b852-0e181a364efd", "matchId": "d22e2123-5207-45f3-8f91-8fe159736ca7", "beatType": null, "evidence": "The section highlights contradictions in TransMedics Group Inc.'s statements and actions.", "position": 1, "isPrimaryArc": true, "parentBeatType": null, "alignedBlockIds": null, "matchConfidence": 0.8 } ], "loops": [], "locked": true }, { "page": 15, "type": "tension", "title": "The slide uses a short-selling thesis style, highlighting valuation concerns and legal/regulatory risks in the medical air transport industry.", "function": "name_villain", "rawType": "villain_critique", "block": null, "metadata": { "slideType": "villain_critique", "slideTypeCanon": { "name": "Villain critique", "slug": "villain_critique", "status": "active", "canonId": "019de52d-10bc-7136-bf20-09de59d17447", "version": 1, "description": null }, "function": "name_villain", "functionCanon": { "name": "Name villain", "slug": "name_villain", "status": "active", "canonId": "019de52d-1746-70d6-bc58-5eeaf5865526", "version": 1, "description": null }, "density": "dense", "densityScore": 65, "componentCount": 7, "textChars": 1924, "nDataPoints": 6, "notes": "The slide uses a short-selling thesis style, highlighting valuation concerns and legal/regulatory risks in the medical air transport industry.", "elementsJson": [ "paragraph", "headline_text", "footnote" ], "confidence": 0.95, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:12:07.808+00", "seconds": 14.048, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/15", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-15", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "The medical air transport industry is high-risk and prone to billing fraud and kickbacks.", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:45:52+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5372-7340-8f99-76785bb4427e", "parentComponentId": null }, { "bbox": { "h": 0.15, "w": 0.4, "x": 0.07, "y": 0.74 }, "kind": "list", "text": "U.S. Air Medical Provider Air Methods Files For Bankruptcy", "attrs": null, "canon": { "kind": { "name": "List", "slug": "list", "status": "active", "canonId": "019de52c-f94b-779b-a53b-fd4904a5f4d2", "version": 1, "description": "Bullet or numbered list." }, "tool": null, "subkind": { "name": "Bullet list", "slug": "bullet", "status": "active", "canonId": "019de52c-fc98-7169-a083-5cab805076ca", "version": 1, "description": null }, "framework": null }, "subkind": "bullet", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:07.808+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "5e99501e-e76e-4d68-8a79-f9d5c0b7b238", "parentComponentId": null }, { "bbox": { "h": 0.15, "w": 0.47, "x": 0.46, "y": 0.74 }, "kind": "list", "text": "Air Medical Transport Company Agrees to Pay $1 Million to Resolve Allegations of False Claims Act Violations", "attrs": null, "canon": { "kind": { "name": "List", "slug": "list", "status": "active", "canonId": "019de52c-f94b-779b-a53b-fd4904a5f4d2", "version": 1, "description": "Bullet or numbered list." }, "tool": null, "subkind": { "name": "Bullet list", "slug": "bullet", "status": "active", "canonId": "019de52c-fc98-7169-a083-5cab805076ca", "version": 1, "description": null }, "framework": null }, "subkind": "bullet", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:07.808+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "d107f3d0-fa5e-4dc3-b2fb-d1d259a5aa45", "parentComponentId": null }, { "bbox": null, "kind": "metric", "text": "EV to product sales: 10X", "attrs": null, "canon": { "kind": { "name": "Metric", "slug": "metric", "status": "active", "canonId": "019de52c-f923-73bf-8081-d0b1a8c5264d", "version": 1, "description": "Big-number or KPI value." }, "tool": { "name": "Quantification", "slug": "quantification", "status": "active", "bestFor": null, "canonId": "019dd9e1-47ab-72ce-a079-aab1f5299e88", "version": 1, "bodyDocId": null, "description": "Translating a claim into numbers, charts, or tables.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": "primary", "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:45:52+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5372-7340-8f99-7a1c88df6a1b", "parentComponentId": null }, { "bbox": { "h": 0.65, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "paragraph", "text": "TransMedics is an airline with a medical device attached, at 7X LTM revenue, a lofty multiple even by speculative midcap metrics. The only relevant measure, of course, is EV to product sales, which at 10X – with those sales tanking sequentially – makes it the most expensive midcap medtech in the US, and 3rd priciest overall, after ISRG ($200B) and GKOS ($8B). Even at an absurd 5X multiple to product sales, the stock would be in the $30’s. The air charter and service half is worthless – a low multiple of book or EBITDA, typical of low-gross margin/high PP&E plays, with PE comps easily available. TransMedics capex is high at $158MM LTM, with net debt even if it liquidated its jets; has no free cash flow; ran losses until recently before becoming slightly profitable, which is likely to revert as sales decline. The medical air transport industry is high-risk and prone to billing fraud and kickbacks. Large players regularly succumb to DOJ investigations. Its competitors Trinity Air Medical and The Nationwide Organ Recovery Transport Alliance (NORA) allegedly engage in dubious practices, and are allegedly under investigation, as we shall cover. Air Methods, owned by private equity, settled with the DOJ in 2023, filing for bankruptcy a few months later after they blew up its business model.", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:07.808+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "075405a2-cfd7-4379-bf75-2f15cc15d252", "parentComponentId": null }, { "bbox": { "h": 0.05, "w": 0.8, "x": 0.07, "y": 0.94 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts; https://www.justice.gov/usao-edky/pr/air-medical-transport-company-agrees-pay-1-million-resolve-allegations-false-claims; https://aviationweek.com/business-aviation/aircraft-propulsion/us-air-medical-provider-air-methods-files-bankruptcy", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:07.808+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "de4d2d50-5604-42f6-89e9-31a62838416f", "parentComponentId": null }, { "bbox": { "h": 0.03, "w": 0.3, "x": 0.07, "y": 0.69 }, "kind": "title", "text": "Air medical transportation – industry articles", "attrs": null, "canon": { "kind": { "name": "Title", "slug": "title", "status": "active", "canonId": "019de52c-f7dd-76d9-b848-b1f12bd85cf4", "version": 1, "description": "Slide title or headline." }, "tool": null, "subkind": { "name": "Subtitle", "slug": "subtitle", "status": "active", "canonId": "019de52c-fb09-739d-900c-815b0d9ac526", "version": 1, "description": null }, "framework": null }, "subkind": "subtitle", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:07.808+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "d44815f2-11bc-4178-926b-e46fa9fc8382", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [], "arcBeats": [ { "to": 20, "arc": { "name": "Overcoming the Monster", "slug": "overcoming-monster", "status": "active", "bestFor": "Competitive positioning, rallying teams", "canonId": "019dd956-6339-76ac-9cbf-4b377c3aa89e", "version": 1, "bodyDocId": "019df22a-2356-73eb-8061-d8c81dc0aa49", "structure": "The Monster -> The Call -> The Struggle -> The Victory -> The New Order", "description": null, "familyLabel": null }, "from": 11, "name": "Critique of TransMedics Group Inc.", "beatId": "c9fa8ec4-9e59-45eb-9317-74367547147c", "matchId": "d22e2123-5207-45f3-8f91-8fe159736ca7", "beatType": null, "evidence": "The section presents a critical analysis of TransMedics Group Inc.'s practices and leadership.", "position": 0, "isPrimaryArc": true, "parentBeatType": null, "alignedBlockIds": null, "matchConfidence": 0.8 }, { "to": 30, "arc": { "name": "Overcoming the Monster", "slug": "overcoming-monster", "status": "active", "bestFor": "Competitive positioning, rallying teams", "canonId": "019dd956-6339-76ac-9cbf-4b377c3aa89e", "version": 1, "bodyDocId": "019df22a-2356-73eb-8061-d8c81dc0aa49", "structure": "The Monster -> The Call -> The Struggle -> The Victory -> The New Order", "description": null, "familyLabel": null }, "from": 12, "name": "Exposure of Contradictions", "beatId": "072007ec-5fd3-4416-b852-0e181a364efd", "matchId": "d22e2123-5207-45f3-8f91-8fe159736ca7", "beatType": null, "evidence": "The section highlights contradictions in TransMedics Group Inc.'s statements and actions.", "position": 1, "isPrimaryArc": true, "parentBeatType": null, "alignedBlockIds": null, "matchConfidence": 0.8 } ], "loops": [], "locked": true }, { "page": 16, "type": "tension", "title": "The slide uses a 'wink-wink' narrative to frame the company's own marketing as evidence of a non-clinical value proposition.", "function": "expose_contradiction", "rawType": "expose_contradiction", "block": null, "metadata": { "slideType": "expose_contradiction", "slideTypeCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-124c-75aa-984a-0a3d0d8fc8df", "version": 1, "description": null }, "function": "expose_contradiction", "functionCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-171f-776f-887c-73edaff4cf9c", "version": 1, "description": null }, "density": "balanced", "densityScore": 48, "componentCount": 7, "textChars": 798, "nDataPoints": 12, "notes": "The slide uses a 'wink-wink' narrative to frame the company's own marketing as evidence of a non-clinical value proposition.", "elementsJson": [ "paragraph", "bar_chart_grouped", "callout_box" ], "confidence": 0.95, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:12:08.706+00", "seconds": 14.666, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/16", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-16", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": ">76% of liver transplants have shifted to day-time transplants using OCS NOP", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-23 01:18:10+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-70f3-714d-84be-cfceacfb0881", "parentComponentId": null }, { "bbox": { "h": 0.35, "w": 0.42, "x": 0.07, "y": 0.59 }, "kind": "chart", "text": "Day-Time Liver Transplant - Game Changer", "attrs": null, "canon": { "kind": { "name": "Chart", "slug": "chart", "status": "active", "canonId": "019de52c-f9a0-76ef-adc6-0b859109d1f8", "version": 1, "description": "Quantitative chart." }, "tool": null, "subkind": { "name": "Grouped bar chart", "slug": "bar-grouped", "status": "active", "canonId": "019de52c-ff3b-751e-a8ff-f21ff11097b1", "version": 1, "description": null }, "framework": null }, "subkind": "bar-grouped", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:08.706+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "8c0416db-b2e3-4c56-a7ab-369f360f10aa", "parentComponentId": null }, { "bbox": { "h": 0.28, "w": 0.42, "x": 0.51, "y": 0.63 }, "kind": "list", "text": ">7,000 US NOP transplants performed to-date & growing rapidly; ~75% & ~55% of US DCD transplants for heart and liver respectively are done using OCS today; 12% US national growth in heart and liver transplant volume primarily driven by OCS and NOP; >76% of liver transplants have shifted to day-time transplants using OCS NOP", "attrs": null, "canon": { "kind": { "name": "List", "slug": "list", "status": "active", "canonId": "019de52c-f94b-779b-a53b-fd4904a5f4d2", "version": 1, "description": "Bullet or numbered list." }, "tool": null, "subkind": { "name": "Bullet list", "slug": "bullet", "status": "active", "canonId": "019de52c-fc98-7169-a083-5cab805076ca", "version": 1, "description": null }, "framework": null }, "subkind": "bullet", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:08.706+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "f1ae3e67-2f44-4219-bbdd-aa643d3624d4", "parentComponentId": null }, { "bbox": null, "kind": "metric", "text": "day-time transplant shift: >76%", "attrs": null, "canon": { "kind": { "name": "Metric", "slug": "metric", "status": "active", "canonId": "019de52c-f923-73bf-8081-d0b1a8c5264d", "version": 1, "description": "Big-number or KPI value." }, "tool": { "name": "Quantification", "slug": "quantification", "status": "active", "bestFor": null, "canonId": "019dd9e1-47ab-72ce-a079-aab1f5299e88", "version": 1, "bodyDocId": null, "description": "Translating a claim into numbers, charts, or tables.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": "primary", "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-23 01:18:10+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-70f3-714d-84be-d6f14935e782", "parentComponentId": null }, { "bbox": { "h": 0.45, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "paragraph", "text": "TransMedics was the first company to get FDA approval for its warm perfusion pump... The wink-wink is visible in TransMedics presentations.", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:08.706+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "5c27c385-c6d4-47b0-b849-1ef1e31ce17b", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "“Don't know, don't care.” — Transplant surgeon", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-23 01:18:10+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-70f3-714d-84be-d1cf5224676b", "parentComponentId": null }, { "bbox": { "h": 0.03, "w": 0.68, "x": 0.07, "y": 0.96 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts; https://investors.transmedics.com/static-files/ae80ac5c-1729-44f6-9c45-4cbb1ff14d7f", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:08.706+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "aa089db9-9171-4e8b-8a32-74522345968d", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [ { "matchId": "906b1912-3aef-4fc1-b9ce-e5d7ba9875fc", "evidence": "The slide explicitly frames the company's marketing as a 'dirty little secret' to expose a contradiction between clinical claims and actual usage drivers.", "framework": null, "confidence": 0.9, "extraction": { "at": "2026-05-02 20:12:08.706+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 16, "frameworkName": "fraud-exposure" } ], "arcBeats": [ { "to": 20, "arc": { "name": "Overcoming the Monster", "slug": "overcoming-monster", "status": "active", "bestFor": "Competitive positioning, rallying teams", "canonId": "019dd956-6339-76ac-9cbf-4b377c3aa89e", "version": 1, "bodyDocId": "019df22a-2356-73eb-8061-d8c81dc0aa49", "structure": "The Monster -> The Call -> The Struggle -> The Victory -> The New Order", "description": null, "familyLabel": null }, "from": 11, "name": "Critique of TransMedics Group Inc.", "beatId": "c9fa8ec4-9e59-45eb-9317-74367547147c", "matchId": "d22e2123-5207-45f3-8f91-8fe159736ca7", "beatType": null, "evidence": "The section presents a critical analysis of TransMedics Group Inc.'s practices and leadership.", "position": 0, "isPrimaryArc": true, "parentBeatType": null, "alignedBlockIds": null, "matchConfidence": 0.8 }, { "to": 30, "arc": { "name": "Overcoming the Monster", "slug": "overcoming-monster", "status": "active", "bestFor": "Competitive positioning, rallying teams", "canonId": "019dd956-6339-76ac-9cbf-4b377c3aa89e", "version": 1, "bodyDocId": "019df22a-2356-73eb-8061-d8c81dc0aa49", "structure": "The Monster -> The Call -> The Struggle -> The Victory -> The New Order", "description": null, "familyLabel": null }, "from": 12, "name": "Exposure of Contradictions", "beatId": "072007ec-5fd3-4416-b852-0e181a364efd", "matchId": "d22e2123-5207-45f3-8f91-8fe159736ca7", "beatType": null, "evidence": "The section highlights contradictions in TransMedics Group Inc.'s statements and actions.", "position": 1, "isPrimaryArc": true, "parentBeatType": null, "alignedBlockIds": null, "matchConfidence": 0.8 } ], "loops": [], "locked": true }, { "page": 17, "type": "tension", "title": "The slide uses highly charged, aggressive language to frame the company and its leadership as predatory and unprofessional.", "function": "name_villain", "rawType": "villain_critique", "block": null, "metadata": { "slideType": "villain_critique", "slideTypeCanon": { "name": "Villain critique", "slug": "villain_critique", "status": "active", "canonId": "019de52d-10bc-7136-bf20-09de59d17447", "version": 1, "description": null }, "function": "name_villain", "functionCanon": { "name": "Name villain", "slug": "name_villain", "status": "active", "canonId": "019de52d-1746-70d6-bc58-5eeaf5865526", "version": 1, "description": null }, "density": "dense", "densityScore": 64, "componentCount": 7, "textChars": 3384, "nDataPoints": 0, "notes": "The slide uses highly charged, aggressive language to frame the company and its leadership as predatory and unprofessional.", "elementsJson": [ "paragraph", "quote_block" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 21:25:48.234+00", "seconds": 3.752, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/17", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-17", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "In 20 years of research, we have never heard anything like the seething, rage, and desire for retribution as on these calls with surgeons and hospitals.", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-23 01:18:10+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-70f3-714d-84be-eb6c5501c96f", "parentComponentId": null }, { "bbox": { "h": 0.35, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "paragraph", "text": "Surgeons described the “lifestyle device” as a game-changer, with a disingenuous clinical pretense to badger hospital administrators into letting them use it – that is, Medicare and the US taxpayer footing the bill for hundreds of thousands of dollars per case, just to accommodate a surgeon’s scheduling preferences. They described it like crack cocaine. And as the only FDA-approved pump that you could sling organs on for days, liver degradation be damned if you have golf on Sunday - TransMedics was the only dealer. Predatory pricing ensued, as it must with any good “FDA monopoly” story. The CEO overplayed a weak hand, after a quarter-century of walking the desert with nothing to show for it except a pulled offering in 2007 - only to promptly shat in and thoroughly poison his own well. Transplant medicine is a small world. In 20 years of research, we have never heard anything like the seething, rage, and desire for retribution as on these calls with surgeons and hospitals.", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:25:48.234+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "2f476c7a-8894-4a8b-a4ec-72bdbe4757e9", "parentComponentId": null }, { "bbox": { "h": 0.25, "w": 0.86, "x": 0.07, "y": 0.62 }, "kind": "quote", "text": "CEO viewed as “an arrogant prick” due to “price gouging”; “people don’t like him”\n“Their CEO is pretty arrogant. He’s an arrogant prick. I mean, look at what they did. They bought $12-13 million aircraft...it works just as well as a $2 million aircraft or lease the damn thing and have a reasonable logistics expense, but it’s just price gouging. It’s unbelievable. It’s not what transplant is meant to be...people don’t like him... If you ask any questions, they are very aggressive and confrontational...it is frankly putting people’s lives in jeopardy. It’s crazy. Personally, we did not agree with some of their business practices...the CEO was on the call... he just launched on me, threatening that if we didn’t want to work with them, then that’s fine. They could take their device elsewhere. I really don’t know how else to explain it. It was just very aggressive. They don’t like receiving questions...” – CEO of a major OPO (Organ Procurement Organization), longtime industry executive", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:25:48.234+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "0918d4bf-6607-4d49-a708-ef0155f569ea", "parentComponentId": null }, { "bbox": { "h": 0.08, "w": 0.86, "x": 0.07, "y": 0.88 }, "kind": "quote", "text": "CEO is “very short-tempered” and “screamed at people a lot”; called customers “idiots”\n“Waleed is very short-tempered. He screamed at people a lot and he could be pretty unprofessional...whenever a customer is asking too many questions, the moment they would leave, he’d be like, “Oh my God, such and such idiots.” – Former longtime employee in senior roles including medical safety and clinical affairs", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:25:48.234+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "235ba08b-fd32-4f92-b367-66bb9b5b3477", "parentComponentId": null }, { "bbox": { "h": 0.15, "w": 0.86, "x": 0.07, "y": 0.45 }, "kind": "quote", "text": "CEO is “so disingenuous” and company is “dishonest”\n“I don’t like Waleed or a lot of their upper management...he’s doing the fake it ’til you make it thing...this goes to show you what a fuck-face he is...he’s so disingenuous... their company, from a corporate culture point of view, is dishonest, to be blunt, and I think their claims are exaggerated.” – Prominent surgeon, Director of a leading academic transplant center", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:25:48.234+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "36aee401-a440-4d64-88ce-c6e878b97646", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "I don't like Waleed or a lot of their upper management...he's doing the fake it 'til you make it thing...this goes to show you what a fuck-face he is...he's so disingenuous... their company, from a corporate culture point of view, is dishonest, to be blunt, and I think their claims are exaggerated. — Prominent surgeon, Director of a leading academic transplant center", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-23 01:18:10+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-70f3-714d-84be-ed5b11290241", "parentComponentId": null }, { "bbox": { "h": 0.02, "w": 0.3, "x": 0.07, "y": 0.96 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:25:48.234+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "3cc2f10b-ee46-4aa8-a6fa-3eef0e091844", "parentComponentId": null } ], "metrics": [], "tools": [ { "tool": { "name": "Anadiplosis", "slug": "anadiplosis", "status": "active", "bestFor": null, "canonId": "019dd956-a0a5-75f9-a98c-7b7d8ee377a1", "version": 1, "bodyDocId": null, "description": "Ending one clause with a word that begins the next", "familyLabel": null, "categoryName": "Loop", "categorySlug": "loop" }, "agent": "Storyteller", "layer": "slide", "agents": [ "Storyteller" ], "matchId": "4293e050-da7b-4ee3-8417-343e27d91a14", "evidence": "The slide uses repetition of negative quotes about the CEO and the company, which is a rhetorical device similar to anadiplosis.", "pageRefs": null, "priority": null, "whenToUse": null, "confidence": 0.7, "extraction": { "at": "2026-07-16 23:10:25.877674+00", "model": "or:meta-llama/llama-4-scout", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 17, "whyItWorks": null, "antipattern": null, "cardinality": null, "narrativePurpose": null }, { "tool": { "name": "Villain slide", "slug": "villain-slide", "status": "active", "bestFor": "In activist decks where the personality matters", "canonId": "019dd9e1-518c-7404-976a-5be5a517b659", "version": 1, "bodyDocId": null, "description": "A dedicated slide presenting the named villain visually", "familyLabel": null, "categoryName": null, "categorySlug": null }, "agent": null, "layer": "slide", "agents": null, "matchId": "e5695b61-d5b6-4930-a3c8-778c9b429d0e", "evidence": "The slide presents a critical view of TransMedics' CEO, describing him as \"an arrogant prick\" and the company as \"dishonest\", which aligns with the characteristics of a villain slide.", "pageRefs": null, "priority": null, "whenToUse": "In activist decks where the personality matters", "confidence": 0.9, "extraction": { "at": "2026-07-16 23:10:25.845382+00", "model": "or:meta-llama/llama-4-scout", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 17, "whyItWorks": "Makes the antagonist concrete", "antipattern": null, "cardinality": null, "narrativePurpose": null } ], "frameworks": [], "arcBeats": [ { "to": 20, "arc": { "name": "Overcoming the Monster", "slug": "overcoming-monster", "status": "active", "bestFor": "Competitive positioning, rallying teams", "canonId": "019dd956-6339-76ac-9cbf-4b377c3aa89e", "version": 1, "bodyDocId": "019df22a-2356-73eb-8061-d8c81dc0aa49", "structure": "The Monster -> The Call -> The Struggle -> The Victory -> The New Order", "description": null, "familyLabel": null }, "from": 11, "name": "Critique of TransMedics Group Inc.", "beatId": "c9fa8ec4-9e59-45eb-9317-74367547147c", "matchId": "d22e2123-5207-45f3-8f91-8fe159736ca7", "beatType": null, "evidence": "The section presents a critical analysis of TransMedics Group Inc.'s practices and leadership.", "position": 0, "isPrimaryArc": true, "parentBeatType": null, "alignedBlockIds": null, "matchConfidence": 0.8 }, { "to": 30, "arc": { "name": "Overcoming the Monster", "slug": "overcoming-monster", "status": "active", "bestFor": "Competitive positioning, rallying teams", "canonId": "019dd956-6339-76ac-9cbf-4b377c3aa89e", "version": 1, "bodyDocId": "019df22a-2356-73eb-8061-d8c81dc0aa49", "structure": "The Monster -> The Call -> The Struggle -> The Victory -> The New Order", "description": null, "familyLabel": null }, "from": 12, "name": "Exposure of Contradictions", "beatId": "072007ec-5fd3-4416-b852-0e181a364efd", "matchId": "d22e2123-5207-45f3-8f91-8fe159736ca7", "beatType": null, "evidence": "The section highlights contradictions in TransMedics Group Inc.'s statements and actions.", "position": 1, "isPrimaryArc": true, "parentBeatType": null, "alignedBlockIds": null, "matchConfidence": 0.8 } ], "loops": [], "locked": true }, { "page": 18, "type": "tension", "title": "The slide uses direct quotes to build a narrative of customer churn risk, specifically highlighting the threat of switching to OrganOX.", "function": "expose_contradiction", "rawType": "testimonial", "block": null, "metadata": { "slideType": "testimonial", "slideTypeCanon": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52d-0a2d-7782-8a48-7e84df92cc97", "version": 1, "description": null }, "function": "expose_contradiction", "functionCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-171f-776f-887c-73edaff4cf9c", "version": 1, "description": null }, "density": "dense", "densityScore": 68, "componentCount": 8, "textChars": 1671, "nDataPoints": 1, "notes": "The slide uses direct quotes to build a narrative of customer churn risk, specifically highlighting the threat of switching to OrganOX.", "elementsJson": [ "paragraph", "quote_block" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:12:10.47+00", "seconds": 16.18, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/18", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-18", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "The loss of just one, we believe, could easily swing a quarter to a miss.", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:45:53+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5372-7340-8f99-bce951ab4d7c", "parentComponentId": null }, { "bbox": { "h": 0.15, "w": 0.85, "x": 0.07, "y": 0.13 }, "kind": "paragraph", "text": "As a preview of a section on enraged customers and the resulting exodus, we quote three large, current customers below. It is self-evident they are not likely to remain so for long.", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:10.47+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "55bf218b-f392-4781-aac4-704434452295", "parentComponentId": null }, { "bbox": { "h": 0.12, "w": 0.85, "x": 0.07, "y": 0.53 }, "kind": "quote", "text": "I hate flying their team all over the fucking country...very little transparency...they could have just made it up...it feels like I’m talking to a used car salesman.", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:10.47+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "38cecac8-6741-4d39-9433-b6a7961c4364", "parentComponentId": null }, { "bbox": { "h": 0.08, "w": 0.85, "x": 0.07, "y": 0.73 }, "kind": "quote", "text": "...TransMedics acted as this hard sell, push down your throat approach to the surgical community saying this is our way or the highway, there are a lot of people they pissed off...", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:10.47+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "41add59d-d79a-4356-852c-2821b4550715", "parentComponentId": null }, { "bbox": { "h": 0.12, "w": 0.85, "x": 0.07, "y": 0.83 }, "kind": "quote", "text": "Typically, this is not how companies behave with somebody who helped them get FDA approval...They play hardball. They've really alienated a lot of people...they're using OrganOX, and they're doing fine.", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:10.47+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "480a3cc9-b192-45fc-b77d-bd8f3fab973f", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "\"I hate flying their team all over the fucking country. I hate it. I hate paying for private jets to fly their surgeons all over. I don't know why we have to pay for all these ridiculous transportation invoices... it feels like I'm talking to a used car salesman.\" — Executive at a pre-eminent academic transplant center; \"...TransMedics acted as this hard sell, push down your throat approach to the surgical community saying this is our way or the highway, there are a lot of people they pissed off\" — Prominent surgeon; \"Typically, this is not how companies behave with somebody who helped them get FDA approval... that's Waleed's method, he and Tamar Khayal, his COO....that's how they roll. They play hardball.\" — Transplant surgeon at a high-volume academic center.", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:45:53+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5372-7340-8f99-c1129e4ecca7", "parentComponentId": null }, { "bbox": { "h": 0.02, "w": 0.3, "x": 0.07, "y": 0.96 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:10.47+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "fecf878b-fa3e-46e4-abdd-5824f4a575df", "parentComponentId": null }, { "bbox": { "h": 0.05, "w": 0.85, "x": 0.07, "y": 0.07 }, "kind": "title", "text": "Enraged Customers and the Resulting Exodus", "attrs": null, "canon": { "kind": { "name": "Title", "slug": "title", "status": "active", "canonId": "019de52c-f7dd-76d9-b848-b1f12bd85cf4", "version": 1, "description": "Slide title or headline." }, "tool": null, "subkind": { "name": "Headline", "slug": "headline", "status": "active", "canonId": "019de52c-fae1-7463-9a7c-d60668eced0d", "version": 1, "description": null }, "framework": null }, "subkind": "headline", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:10.47+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "9f326149-8756-4301-b4d5-7a446e6838a0", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [ { "matchId": "e22c7a23-7b36-4135-9723-1486504e986a", "evidence": "Direct quotes from customers used to validate a business thesis.", "framework": null, "confidence": 1, "extraction": { "at": "2026-05-02 20:12:10.47+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 18, "frameworkName": "testimonial" } ], "arcBeats": [ { "to": 20, "arc": { "name": "Overcoming the Monster", "slug": "overcoming-monster", "status": "active", "bestFor": "Competitive positioning, rallying teams", "canonId": "019dd956-6339-76ac-9cbf-4b377c3aa89e", "version": 1, "bodyDocId": "019df22a-2356-73eb-8061-d8c81dc0aa49", "structure": "The Monster -> The Call -> The Struggle -> The Victory -> The New Order", "description": null, "familyLabel": null }, "from": 11, "name": "Critique of TransMedics Group Inc.", "beatId": "c9fa8ec4-9e59-45eb-9317-74367547147c", "matchId": "d22e2123-5207-45f3-8f91-8fe159736ca7", "beatType": null, "evidence": "The section presents a critical analysis of TransMedics Group Inc.'s practices and leadership.", "position": 0, "isPrimaryArc": true, "parentBeatType": null, "alignedBlockIds": null, "matchConfidence": 0.8 }, { "to": 30, "arc": { "name": "Overcoming the Monster", "slug": "overcoming-monster", "status": "active", "bestFor": "Competitive positioning, rallying teams", "canonId": "019dd956-6339-76ac-9cbf-4b377c3aa89e", "version": 1, "bodyDocId": "019df22a-2356-73eb-8061-d8c81dc0aa49", "structure": "The Monster -> The Call -> The Struggle -> The Victory -> The New Order", "description": null, "familyLabel": null }, "from": 12, "name": "Exposure of Contradictions", "beatId": "072007ec-5fd3-4416-b852-0e181a364efd", "matchId": "d22e2123-5207-45f3-8f91-8fe159736ca7", "beatType": null, "evidence": "The section highlights contradictions in TransMedics Group Inc.'s statements and actions.", "position": 1, "isPrimaryArc": true, "parentBeatType": null, "alignedBlockIds": null, "matchConfidence": 0.8 } ], "loops": [], "locked": true }, { "page": 19, "type": "tension", "title": "The slide uses a combination of narrative summary and a direct Q&A transcript excerpt to substantiate claims of unethical conduct.", "function": "name_villain", "rawType": "villain_critique", "block": null, "metadata": { "slideType": "villain_critique", "slideTypeCanon": { "name": "Villain critique", "slug": "villain_critique", "status": "active", "canonId": "019de52d-10bc-7136-bf20-09de59d17447", "version": 1, "description": null }, "function": "name_villain", "functionCanon": { "name": "Name villain", "slug": "name_villain", "status": "active", "canonId": "019de52d-1746-70d6-bc58-5eeaf5865526", "version": 1, "description": null }, "density": "dense", "densityScore": 51, "componentCount": 6, "textChars": 2013, "nDataPoints": 0, "notes": "The slide uses a combination of narrative summary and a direct Q&A transcript excerpt to substantiate claims of unethical conduct.", "elementsJson": [ "paragraph", "quote_block" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 21:25:47.561+00", "seconds": 3.053, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/19", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-19", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "TransMedics, as we shall get to, is a cesspool of nepotism, an infrequent but reliable red flag.", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:45:54+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5372-7340-8f99-d174658a7a38", "parentComponentId": null }, { "bbox": { "h": 0.25, "w": 0.85, "x": 0.07, "y": 0.15 }, "kind": "paragraph", "text": "The CEO's sister, Amira Hassanein, runs the failed lung program. Customers described her as “confrontational” as her brother, allegedly coercing surgeons to accept and transplant organs they had already rejected as dangerous to their patient...", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:25:47.561+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "9d565f8e-fd96-4d08-b430-7690616490ac", "parentComponentId": null }, { "bbox": { "h": 0.32, "w": 0.85, "x": 0.07, "y": 0.61 }, "kind": "quote", "text": "CEO's sister allegedly badgering people to transplant defective lungs. Q: ... A: “Waleed's sister is in charge of the lung program....she is the one that I have witnessed do this...\"", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:25:47.561+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "d12f9af3-97d7-4b81-86a9-b9deae3adcf7", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "Waleed’s sister is in charge of the lung program....she is the one that I have witnessed do this. We had some lungs in that situation where the accepting center declined; the bronch was not good. The lungs were contused when they were recovered and I was able to witness some of those conversations myself....these calls are 100% happening...I saw her on the line with a transplant surgeon who’s trying to weigh the clinical outcome for her recipient. And Amina would be on the line with her, just insisting that these lungs would have a good outcome after they were transplanted. I was thinking, ‘How do you even know that?’ This is confusing. I’m also not a surgeon, but it just seemed well beyond her scope to insist, badger a surgeon who made a decision that transplanting this organ could put her patient in jeopardy and to sit here for 15 minutes working to actively convince them to make a different clinical decision, I’ve never seen anything like that...confrontational, speaking over people, really speaking as if she’s their boss, their attending surgeon, insisting that organ will have a good outcome and that they’re jeopardizing the patient’s safety if they don’t transplant it, and it’s all because “you don’t understand the machine. You don’t understand the machine.” — Executive at a leading OPO, longtime industry veteran", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:45:54+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5372-7340-8f99-d7405c2f3723", "parentComponentId": null }, { "bbox": { "h": 0.03, "w": 0.3, "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:25:47.561+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "afb26b52-b2fd-4897-ab46-ee5a398b4b08", "parentComponentId": null }, { "bbox": { "h": 0.08, "w": 0.85, "x": 0.07, "y": 0.07 }, "kind": "title", "text": "TransMedics, as we shall get to, is a cesspool of nepotism, an infrequent but reliable red flag.", "attrs": null, "canon": { "kind": { "name": "Title", "slug": "title", "status": "active", "canonId": "019de52c-f7dd-76d9-b848-b1f12bd85cf4", "version": 1, "description": "Slide title or headline." }, "tool": null, "subkind": { "name": "Headline", "slug": "headline", "status": "active", "canonId": "019de52c-fae1-7463-9a7c-d60668eced0d", "version": 1, "description": null }, "framework": null }, "subkind": "headline", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:25:47.561+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "b967303f-29db-4d74-8dbc-2406e90d4f42", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [], "arcBeats": [ { "to": 20, "arc": { "name": "Overcoming the Monster", "slug": "overcoming-monster", "status": "active", "bestFor": "Competitive positioning, rallying teams", "canonId": "019dd956-6339-76ac-9cbf-4b377c3aa89e", "version": 1, "bodyDocId": "019df22a-2356-73eb-8061-d8c81dc0aa49", "structure": "The Monster -> The Call -> The Struggle -> The Victory -> The New Order", "description": null, "familyLabel": null }, "from": 11, "name": "Critique of TransMedics Group Inc.", "beatId": "c9fa8ec4-9e59-45eb-9317-74367547147c", "matchId": "d22e2123-5207-45f3-8f91-8fe159736ca7", "beatType": null, "evidence": "The section presents a critical analysis of TransMedics Group Inc.'s practices and leadership.", "position": 0, "isPrimaryArc": true, "parentBeatType": null, "alignedBlockIds": null, "matchConfidence": 0.8 }, { "to": 30, "arc": { "name": "Overcoming the Monster", "slug": "overcoming-monster", "status": "active", "bestFor": "Competitive positioning, rallying teams", "canonId": "019dd956-6339-76ac-9cbf-4b377c3aa89e", "version": 1, "bodyDocId": "019df22a-2356-73eb-8061-d8c81dc0aa49", "structure": "The Monster -> The Call -> The Struggle -> The Victory -> The New Order", "description": null, "familyLabel": null }, "from": 12, "name": "Exposure of Contradictions", "beatId": "072007ec-5fd3-4416-b852-0e181a364efd", "matchId": "d22e2123-5207-45f3-8f91-8fe159736ca7", "beatType": null, "evidence": "The section highlights contradictions in TransMedics Group Inc.'s statements and actions.", "position": 1, "isPrimaryArc": true, "parentBeatType": null, "alignedBlockIds": null, "matchConfidence": 0.8 } ], "loops": [], "locked": true }, { "page": 20, "type": "tension", "title": "The slide uses strong, emotive language ('greedy', 'predatory', 'hate') to frame the company as a villain in the transplant market.", "function": "name_villain", "rawType": "villain_critique", "block": null, "metadata": { "slideType": "villain_critique", "slideTypeCanon": { "name": "Villain critique", "slug": "villain_critique", "status": "active", "canonId": "019de52d-10bc-7136-bf20-09de59d17447", "version": 1, "description": null }, "function": "name_villain", "functionCanon": { "name": "Name villain", "slug": "name_villain", "status": "active", "canonId": "019de52d-1746-70d6-bc58-5eeaf5865526", "version": 1, "description": null }, "density": "balanced", "densityScore": 42, "componentCount": 6, "textChars": 1075, "nDataPoints": 1, "notes": "The slide uses strong, emotive language ('greedy', 'predatory', 'hate') to frame the company as a villain in the transplant market.", "elementsJson": [ "paragraph", "quote_block" ], "confidence": 0.95, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:12:07.177+00", "seconds": 12.191, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/20", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-20", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "The speed of the meltdown may be one for the ages as its largest users stampede.", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-23 01:18:10+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-70f3-714d-84be-fd49f1662dce", "parentComponentId": null }, { "bbox": { "h": 0.45, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "paragraph", "text": "The problem for TransMedics is that its monopoly position was fleeting. Cheaper, better pumps and preservation devices have been approved, with a second wave in the FDA queue. The transplant field is ready to pounce...", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:07.177+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "951ddd66-e45e-4e09-a0bd-977694c99101", "parentComponentId": null }, { "bbox": { "h": 0.25, "w": 0.86, "x": 0.07, "y": 0.58 }, "kind": "quote", "text": "I don't like the Transmedics people that much... a lot of people are very pissed off with the company... because they are acting too greedy and predatory... I can tell you, I hate the CEO.", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:07.177+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "4163214b-7ca6-44d7-a7af-d0929b137435", "parentComponentId": null }, { "bbox": { "h": 0.1, "w": 0.86, "x": 0.07, "y": 0.85 }, "kind": "quote", "text": "Vanderbilt is the biggest heart transplant program not in the country but in the world. They do zero TransMedics. Zero because they are so upset. They really hate it.", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:07.177+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "f64984b0-f2aa-46b9-9311-37b0eb07f0ca", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "I don’t like the Transmedics people that much...a lot of people are very pissed off with the company...because they are acting too greedy and predatory. I really support that letter from that Congressman. Again, a lot of people in different transplant centers are very pissed off with the company.... I can tell you, I hate the CEO. — Transplant surgeon at Vanderbilt", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-23 01:18:10+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-70f3-714d-84bf-03cc8d9b159c", "parentComponentId": null }, { "bbox": { "h": 0.03, "w": 0.3, "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:07.177+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "6c6c8ed1-23ba-40ad-9cbc-e0f31e0ee48a", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [ { "matchId": "c6a0d48f-05a7-4bb7-867e-854b2d135387", "evidence": "The slide explicitly frames the company as 'greedy' and 'predatory' to justify a short thesis.", "framework": null, "confidence": 0.9, "extraction": { "at": "2026-05-02 20:12:07.177+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 20, "frameworkName": "antagonist-introduction" } ], "arcBeats": [ { "to": 20, "arc": { "name": "Overcoming the Monster", "slug": "overcoming-monster", "status": "active", "bestFor": "Competitive positioning, rallying teams", "canonId": "019dd956-6339-76ac-9cbf-4b377c3aa89e", "version": 1, "bodyDocId": "019df22a-2356-73eb-8061-d8c81dc0aa49", "structure": "The Monster -> The Call -> The Struggle -> The Victory -> The New Order", "description": null, "familyLabel": null }, "from": 11, "name": "Critique of TransMedics Group Inc.", "beatId": "c9fa8ec4-9e59-45eb-9317-74367547147c", "matchId": "d22e2123-5207-45f3-8f91-8fe159736ca7", "beatType": null, "evidence": "The section presents a critical analysis of TransMedics Group Inc.'s practices and leadership.", "position": 0, "isPrimaryArc": true, "parentBeatType": null, "alignedBlockIds": null, "matchConfidence": 0.8 }, { "to": 30, "arc": { "name": "Overcoming the Monster", "slug": "overcoming-monster", "status": "active", "bestFor": "Competitive positioning, rallying teams", "canonId": "019dd956-6339-76ac-9cbf-4b377c3aa89e", "version": 1, "bodyDocId": "019df22a-2356-73eb-8061-d8c81dc0aa49", "structure": "The Monster -> The Call -> The Struggle -> The Victory -> The New Order", "description": null, "familyLabel": null }, "from": 12, "name": "Exposure of Contradictions", "beatId": "072007ec-5fd3-4416-b852-0e181a364efd", "matchId": "d22e2123-5207-45f3-8f91-8fe159736ca7", "beatType": null, "evidence": "The section highlights contradictions in TransMedics Group Inc.'s statements and actions.", "position": 1, "isPrimaryArc": true, "parentBeatType": null, "alignedBlockIds": null, "matchConfidence": 0.8 } ], "loops": [], "locked": true }, { "page": 21, "type": "tension", "title": "The slide uses a combination of narrative analysis and direct testimonial quotes to build a bearish case against the company.", "function": "expose_contradiction", "rawType": "villain_critique", "block": null, "metadata": { "slideType": "villain_critique", "slideTypeCanon": { "name": "Villain critique", "slug": "villain_critique", "status": "active", "canonId": "019de52d-10bc-7136-bf20-09de59d17447", "version": 1, "description": null }, "function": "expose_contradiction", "functionCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-171f-776f-887c-73edaff4cf9c", "version": 1, "description": null }, "density": "balanced", "densityScore": 46, "componentCount": 5, "textChars": 1575, "nDataPoints": 3, "notes": "The slide uses a combination of narrative analysis and direct testimonial quotes to build a bearish case against the company.", "elementsJson": [ "paragraph", "quote_block" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:12:03.178+00", "seconds": 7.775, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/21", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-21", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "With Vanderbilt gone and UCSF/MGH next – three of the top centers in the US and globally, by case volumes and influence – it is game, set, match.", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:45:54+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5372-7340-8f9a-20ab3c3fd0ae", "parentComponentId": null }, { "bbox": { "h": 0.62, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "paragraph", "text": "UCSF, Massachusetts General, UCSD, and Cedars-Sinai are just a partial set of the large, current customers we spoke with who are on the verge of fleeing - all of it, we believe, yet to reflect in the coming quarters.", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:03.178+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "96a7b3db-139e-4944-acf2-b7c191dcfb3a", "parentComponentId": null }, { "bbox": { "h": 0.22, "w": 0.86, "x": 0.07, "y": 0.72 }, "kind": "quote", "text": "Yeah, that's what's going to happen. It's not new technology, I mean, it's been around for a while. Like NRP, I think it's going to be a huge game-changer.", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:03.178+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "50231914-ec5f-48eb-b5b6-ca23ac64d1e5", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "Like NRP, I think it’s going to be a huge game-changer. And you see some of this initial data that’s coming out even from Europe, and you’re like, “Why are we not doing this?” NRP is going to probably be standard. There’s going to be no real utility in using an OCS in comparison to other cheaper, more widely available, and more preferable from a business-to-business standpoint—it’s a no-brainer. [...] For livers, probably in the next six months [...] I think we’ll probably stop using it. It’s gotten to that point [...] the market has shifted...the clinicians who have been very, very concerned about the poor business practices and misalignment of incentives with TransMedics, that there are now going to be other technologies...it’s very promising that there’s going to be a different option, not only from the actual product standpoint but just from a business standpoint, I would switch right away. — Veteran transplant administrator/executive in a senior role at Massachusetts General Hospital", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:45:54+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5372-7340-8f9a-26d2e41ac42b", "parentComponentId": null }, { "bbox": { "h": 0.03, "w": 0.3, "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:03.178+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "f111030d-fbed-446c-8381-a3465c4a43c1", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [ { "matchId": "2dfee5ea-b5b1-4e66-9de4-3b1eef66c085", "evidence": "The slide frames TransMedics as the antagonist in a narrative of customer dissatisfaction and business failure.", "framework": null, "confidence": 0.8, "extraction": { "at": "2026-05-02 20:12:03.178+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 21, "frameworkName": "antagonist-introduction" } ], "arcBeats": [ { "to": 30, "arc": { "name": "Overcoming the Monster", "slug": "overcoming-monster", "status": "active", "bestFor": "Competitive positioning, rallying teams", "canonId": "019dd956-6339-76ac-9cbf-4b377c3aa89e", "version": 1, "bodyDocId": "019df22a-2356-73eb-8061-d8c81dc0aa49", "structure": "The Monster -> The Call -> The Struggle -> The Victory -> The New Order", "description": null, "familyLabel": null }, "from": 12, "name": "Exposure of Contradictions", "beatId": "072007ec-5fd3-4416-b852-0e181a364efd", "matchId": "d22e2123-5207-45f3-8f91-8fe159736ca7", "beatType": null, "evidence": "The section highlights contradictions in TransMedics Group Inc.'s statements and actions.", "position": 1, "isPrimaryArc": true, "parentBeatType": null, "alignedBlockIds": null, "matchConfidence": 0.8 } ], "loops": [], "locked": true }, { "page": 22, "type": "tension", "title": "The slide uses aggressive, short-selling style language ('colossal failure', 'crashing and burning', 'one-trick pony').", "function": "name_villain", "rawType": "villain_critique", "block": null, "metadata": { "slideType": "villain_critique", "slideTypeCanon": { "name": "Villain critique", "slug": "villain_critique", "status": "active", "canonId": "019de52d-10bc-7136-bf20-09de59d17447", "version": 1, "description": null }, "function": "name_villain", "functionCanon": { "name": "Name villain", "slug": "name_villain", "status": "active", "canonId": "019de52d-1746-70d6-bc58-5eeaf5865526", "version": 1, "description": null }, "density": "balanced", "densityScore": 30, "componentCount": 5, "textChars": 786, "nDataPoints": 1, "notes": "The slide uses aggressive, short-selling style language ('colossal failure', 'crashing and burning', 'one-trick pony').", "elementsJson": [ "paragraph", "photo" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:12:05.654+00", "seconds": 10.226, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/22", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-22", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "The bull case - a multi-organ platform - leaves out a few inconvenient facts: it flopped in Europe; has no kidney product, the largest market by far, as a cheap device has a lock with 90% share; lung, its first FDA-approval in 2018, is a colossal failure; heart, approved in 2021, is crashing and burning; leaving it, best case, as a one-trick pony for a single organ - liver.", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:45:57+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5372-7340-8f9b-d051632dad5a", "parentComponentId": null }, { "bbox": { "h": 0.28, "w": 0.65, "x": 0.07, "y": 0.63 }, "kind": "image", "text": "TransMedics product line", "attrs": null, "canon": { "kind": { "name": "Image", "slug": "image", "status": "active", "canonId": "019de52c-f978-701f-a720-51d029d769e7", "version": 1, "description": "Photo, illustration, screenshot or icon." }, "tool": null, "subkind": { "name": "Infographic", "slug": "infographic", "status": "active", "canonId": "019de52c-fe26-750c-9d7d-9f34e21324e8", "version": 1, "description": null }, "framework": null }, "subkind": "infographic", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:05.654+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "7f6099eb-3e0f-4b21-8ba5-9a766a2cddf3", "parentComponentId": null }, { "bbox": { "h": 0.42, "w": 0.86, "x": 0.07, "y": 0.16 }, "kind": "paragraph", "text": "Since the 1960's, static cold storage has been the standard of care... TransMedics sells a 'normothermic machine perfusion' (NMP) system... The bull case... leaves out a few inconvenient facts...", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:05.654+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "9c8b78ed-4d31-4b3e-bd93-e98b431cc384", "parentComponentId": null }, { "bbox": { "h": 0.02, "w": 0.48, "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts; image is from TransMedics SEC filings", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:05.654+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "6c4b91c9-ad3b-4b2d-aade-7c91bde60075", "parentComponentId": null }, { "bbox": { "h": 0.08, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "title", "text": "The speed of TransMedics meltdown is due to a simple fact: it has no clinical value proposition.", "attrs": null, "canon": { "kind": { "name": "Title", "slug": "title", "status": "active", "canonId": "019de52c-f7dd-76d9-b848-b1f12bd85cf4", "version": 1, "description": "Slide title or headline." }, "tool": null, "subkind": { "name": "Headline", "slug": "headline", "status": "active", "canonId": "019de52c-fae1-7463-9a7c-d60668eced0d", "version": 1, "description": null }, "framework": null }, "subkind": "headline", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:05.654+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "bfd97df6-d6c3-4754-9ba7-47e6fc662268", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [], "arcBeats": [ { "to": 30, "arc": { "name": "Overcoming the Monster", "slug": "overcoming-monster", "status": "active", "bestFor": "Competitive positioning, rallying teams", "canonId": "019dd956-6339-76ac-9cbf-4b377c3aa89e", "version": 1, "bodyDocId": "019df22a-2356-73eb-8061-d8c81dc0aa49", "structure": "The Monster -> The Call -> The Struggle -> The Victory -> The New Order", "description": null, "familyLabel": null }, "from": 12, "name": "Exposure of Contradictions", "beatId": "072007ec-5fd3-4416-b852-0e181a364efd", "matchId": "d22e2123-5207-45f3-8f91-8fe159736ca7", "beatType": null, "evidence": "The section highlights contradictions in TransMedics Group Inc.'s statements and actions.", "position": 1, "isPrimaryArc": true, "parentBeatType": null, "alignedBlockIds": null, "matchConfidence": 0.8 } ], "loops": [], "locked": true }, { "page": 23, "type": "tension", "title": "The slide uses a sarcastic tone to undermine the company's intellectual property claims.", "function": "name_villain", "rawType": "villain_critique", "block": null, "metadata": { "slideType": "villain_critique", "slideTypeCanon": { "name": "Villain critique", "slug": "villain_critique", "status": "active", "canonId": "019de52d-10bc-7136-bf20-09de59d17447", "version": 1, "description": null }, "function": "name_villain", "functionCanon": { "name": "Name villain", "slug": "name_villain", "status": "active", "canonId": "019de52d-1746-70d6-bc58-5eeaf5865526", "version": 1, "description": null }, "density": "balanced", "densityScore": 28, "componentCount": 4, "textChars": 833, "nDataPoints": 1, "notes": "The slide uses a sarcastic tone to undermine the company's intellectual property claims.", "elementsJson": [ "paragraph", "photo" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:12:02.742+00", "seconds": 7.093, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/23", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-23", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "Some transplant surgeons told us their centers had rigged their own versions for a couple of thousand bucks – with duct tape after a Home Depot run, we assume.", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:45:54+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5372-7340-8f9a-0e9163d6c921", "parentComponentId": null }, { "bbox": { "h": 0.5, "w": 0.45, "x": 0.07, "y": 0.4 }, "kind": "image", "text": "TransMedics OCS device in the field", "attrs": null, "canon": { "kind": { "name": "Image", "slug": "image", "status": "active", "canonId": "019de52c-f978-701f-a720-51d029d769e7", "version": 1, "description": "Photo, illustration, screenshot or icon." }, "tool": null, "subkind": { "name": "Photo", "slug": "photo", "status": "active", "canonId": "019de52c-fd37-757f-b4a8-ca26d4888875", "version": 1, "description": null }, "framework": null }, "subkind": "photo", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:02.742+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "69826757-f01b-47ca-bd5f-0e0cad33e0ee", "parentComponentId": null }, { "bbox": { "h": 0.28, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "paragraph", "text": "The concept as well as the “intellectual property” for TransMedics perfusion system have been around since the 1930’s – a plastic bucket, some tubing, a little pump, a heater, and a novel therapeutic solution called “PlasmaLyte perfusate,” which we realized after an exhausting 30 seconds of research is an electrolyte brand sold online by Baxter, the same as Gatorade or Pedialyte, jacked up to $400 for the IV drip bag. Some transplant surgeons told us their centers had rigged their own versions for a couple of thousand bucks – with duct tape after a Home Depot run, we assume.", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:02.742+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "3466b6c1-c583-45ba-b35c-c55fa2645a78", "parentComponentId": null }, { "bbox": { "h": 0.03, "w": 0.3, "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: https://x.com/yeshikims/status/1738423821139329091", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:02.742+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "8616f670-09b3-4002-a92d-57331d809e76", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [], "arcBeats": [ { "to": 30, "arc": { "name": "Overcoming the Monster", "slug": "overcoming-monster", "status": "active", "bestFor": "Competitive positioning, rallying teams", "canonId": "019dd956-6339-76ac-9cbf-4b377c3aa89e", "version": 1, "bodyDocId": "019df22a-2356-73eb-8061-d8c81dc0aa49", "structure": "The Monster -> The Call -> The Struggle -> The Victory -> The New Order", "description": null, "familyLabel": null }, "from": 12, "name": "Exposure of Contradictions", "beatId": "072007ec-5fd3-4416-b852-0e181a364efd", "matchId": "d22e2123-5207-45f3-8f91-8fe159736ca7", "beatType": null, "evidence": "The section highlights contradictions in TransMedics Group Inc.'s statements and actions.", "position": 1, "isPrimaryArc": true, "parentBeatType": null, "alignedBlockIds": null, "matchConfidence": 0.8 } ], "loops": [], "locked": true }, { "page": 24, "type": "tension", "title": "The slide uses a 'villain' framing to attack the company's business model as exploitative of the US healthcare system.", "function": "name_villain", "rawType": "villain_critique", "block": null, "metadata": { "slideType": "villain_critique", "slideTypeCanon": { "name": "Villain critique", "slug": "villain_critique", "status": "active", "canonId": "019de52d-10bc-7136-bf20-09de59d17447", "version": 1, "description": null }, "function": "name_villain", "functionCanon": { "name": "Name villain", "slug": "name_villain", "status": "active", "canonId": "019de52d-1746-70d6-bc58-5eeaf5865526", "version": 1, "description": null }, "density": "dense", "densityScore": 70, "componentCount": 7, "textChars": 3124, "nDataPoints": 6, "notes": "The slide uses a 'villain' framing to attack the company's business model as exploitative of the US healthcare system.", "elementsJson": [ "paragraph", "quote_block" ], "confidence": 0.95, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:12:04.27+00", "seconds": 8.563, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/24", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-24", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "TransMedics pump is the kind of obscene, unnecessary contraption that can only exist in the US healthcare system – the Medicare equivalent of the $10,000 toilet seat, $400 screw, and other schemes by defense contractors to fleece the federal government.", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-23 01:18:10+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-70f3-714d-84bf-1286894752ad", "parentComponentId": null }, { "bbox": { "h": 0.25, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "paragraph", "text": "No one bothered to manufacture a warm perfusion pump for 50 years prior to TransMedics, as static cold storage worked fine. But you can't scam Medicare for a $70-90K consumable if you sell ice, plus another $50K to $300K in air transport fees...", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:04.27+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "7b8eca72-fc05-4f66-9eb8-e44f373bf5d6", "parentComponentId": null }, { "bbox": { "h": 0.12, "w": 0.86, "x": 0.07, "y": 0.83 }, "kind": "quote", "text": "The problem with the marketing is that they've expanded use which doesn't need to be expanded... You're replacing a very cheap technology that costs a few thousand dollars with one that costs $100,000... patient and graft survival are no different.", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:04.27+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "2c68ea65-782f-4bfc-aa26-60020dfe3935", "parentComponentId": null }, { "bbox": { "h": 0.15, "w": 0.86, "x": 0.07, "y": 0.47 }, "kind": "quote", "text": "Why should it cost $70,000-80,000 for disposables? The disposables are essentially plastic tubings and plastic containers and cartridges... It is, no question, overpriced... there's no question NRP is picking up.", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:04.27+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "2d3108dd-581e-4008-a628-dfa624a950d6", "parentComponentId": null }, { "bbox": { "h": 0.15, "w": 0.86, "x": 0.07, "y": 0.65 }, "kind": "quote", "text": "I don't think there's any magic to TransMedics per se. It's got cute bells and whistles; it travels. Let's face it: there's no secret sauce in this... there's a low threshold to jump over.", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:04.27+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "d7e65cfa-cd32-4f6a-91d2-b3b4090297f1", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "\"Why should it cost $70,000-80,000 for disposables? The disposables are essentially plastic tubings and plastic containers and cartridges, and that's more than the cost of a brand-new luxury car that you're paying for a set of things that you throw in the garbage, essentially. It is, no question, overpriced...there's lots of precedence for this sort of stuff happening in the healthcare industry...you have all these other devices that are coming in, and the price will go down...on top of which...there's no question NRP is picking up.\" — Transplant surgeon and transplant program director at a leading Northeast academic center; \"I don't think there's any magic to TransMedics per se. It's got cute bells and whistles; it travels. Let's face it: there's no secret sauce in this. Perfusion is in many ways perfusion and, in this case, normothermic perfusion is normothermic perfusion. It would be very hard to ascribe a special quality to one modality necessarily over another. If you can get that with one device comparably to another and logistically it's less challenging and certainly a whole lot less costly, then you go that way, there's no question. So, I think there will be a low threshold to jump over.\" — Transplant hepatologist in a leadership role at Harvard/Massachusetts General Hospital; \"The problem with the marketing is that they've expanded use which doesn't need to be expanded. In other words, they're talking about an $8 billion industry. That means that every organ would be pumped on the machine at $100,000; it's ridiculous. You're replacing a very cheap technology that costs a few thousand dollars with one that costs $100,000...one thing that you can take away from all of these studies also is that the patient and graft survival are no different between the cold storage and machine perfusion...\" — One of the top liver transplant surgeons in the world, based at a leading academic center", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-23 01:18:10+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-70f3-714d-84bf-1610bf469618", "parentComponentId": null }, { "bbox": { "h": 0.02, "w": 0.3, "x": 0.07, "y": 0.96 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:04.27+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "dbb6296c-4b74-45e4-ab08-231b33ad433b", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [ { "matchId": "9385638e-8559-4959-b326-f91904efb43d", "evidence": "The slide frames TransMedics as a 'villain' exploiting the healthcare system.", "framework": null, "confidence": 0.9, "extraction": { "at": "2026-05-02 20:12:04.27+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 24, "frameworkName": "antagonist-introduction" } ], "arcBeats": [ { "to": 30, "arc": { "name": "Overcoming the Monster", "slug": "overcoming-monster", "status": "active", "bestFor": "Competitive positioning, rallying teams", "canonId": "019dd956-6339-76ac-9cbf-4b377c3aa89e", "version": 1, "bodyDocId": "019df22a-2356-73eb-8061-d8c81dc0aa49", "structure": "The Monster -> The Call -> The Struggle -> The Victory -> The New Order", "description": null, "familyLabel": null }, "from": 12, "name": "Exposure of Contradictions", "beatId": "072007ec-5fd3-4416-b852-0e181a364efd", "matchId": "d22e2123-5207-45f3-8f91-8fe159736ca7", "beatType": null, "evidence": "The section highlights contradictions in TransMedics Group Inc.'s statements and actions.", "position": 1, "isPrimaryArc": true, "parentBeatType": null, "alignedBlockIds": null, "matchConfidence": 0.8 } ], "loops": [], "locked": true }, { "page": 25, "type": "tension", "title": "The slide uses a 'villain critique' approach to frame the company's business model as a 'government pay scam'.", "function": "expose_contradiction", "rawType": "villain_critique", "block": null, "metadata": { "slideType": "villain_critique", "slideTypeCanon": { "name": "Villain critique", "slug": "villain_critique", "status": "active", "canonId": "019de52d-10bc-7136-bf20-09de59d17447", "version": 1, "description": null }, "function": "expose_contradiction", "functionCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-171f-776f-887c-73edaff4cf9c", "version": 1, "description": null }, "density": "overcrowded", "densityScore": 83, "componentCount": 10, "textChars": 3046, "nDataPoints": 0, "notes": "The slide uses a 'villain critique' approach to frame the company's business model as a 'government pay scam'.", "elementsJson": [ "paragraph", "callout_box" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:12:11.767+00", "seconds": 15.719, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/25", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-25", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": { "h": 0.08, "w": 0.85, "x": 0.07, "y": 0.83 }, "kind": "callout", "text": "CEO openly promotes the Medicare loophole\n“Waleed will talk about it all the time. If you listen to any of his investor calls, he will talk about how Medicare pays the cost. What are you guys worried about?..” – Former executive in a key reimbursement role", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": null, "subkind": { "name": "Primary callout", "slug": "primary", "status": "active", "canonId": "019de52c-fbd1-70eb-a9ce-8997f8674c1d", "version": 1, "description": null }, "framework": null }, "subkind": "primary", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:11.767+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "376ce54d-cbfc-4187-a557-e429192b633f", "parentComponentId": null }, { "bbox": { "h": 0.2, "w": 0.85, "x": 0.07, "y": 0.62 }, "kind": "callout", "text": "Medicare Cost Report structure explanation - “it’s totally crazy”\n“In the Gosar letter, it talked about overcharging. And going back to what the CEO would want to hide - reimbursement for organ acquisition, which OCS falls squarely into. The way the structure - it’s totally crazy....all of the costs to procure an organ, as long as they are reasonable and necessary, they go on the organ transplant worksheet or organ procurement worksheet on what’s called the Medicare Cost Report, which is an annual filing and every hospital in the country does whether they’re a transplant program or not because that program has a specific worksheet that lists all of the costs of what they incurred to procure the organ. And that is paid at cost plus the overhead rate that varies between 17-25%, depending on the hospital. So, everything they spent—so if they pay for an OCS system on the NOP with the flight, then all of those costs get paid at cost plus back to the hospital…” – Former executive in a key reimbursement role", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": null, "subkind": { "name": "Primary callout", "slug": "primary", "status": "active", "canonId": "019de52c-fbd1-70eb-a9ce-8997f8674c1d", "version": 1, "description": null }, "framework": null }, "subkind": "primary", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:11.767+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "a1cfcfd1-bc72-4878-b9fa-a82182491efc", "parentComponentId": null }, { "bbox": null, "kind": "callout", "text": "Perverse incentives are central to understanding TransMedics business model. It exists solely as a creature of a preposterous Medicare reimbursement loophole unique to transplants – which regulators are racing to kill off, unbeknownst to bulls, taking TransMedics down with it.", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:45:55+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5372-7340-8f9a-7628967eccbd", "parentComponentId": null }, { "bbox": { "h": 0.1, "w": 0.85, "x": 0.07, "y": 0.31 }, "kind": "paragraph", "text": "Medicare reimburses transplant centers for all reasonable and necessary organ acquisition charges, which are rolled up into each center’s Medicare Cost Report. The rub: organ acquisition charges - which include TransMedics device and NOP fees - have no cap, as “reasonable” is undefined.", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:11.767+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "0581c9a5-9ed3-425e-adc0-1e2d6b2e7c9a", "parentComponentId": null }, { "bbox": { "h": 0.06, "w": 0.85, "x": 0.07, "y": 0.25 }, "kind": "paragraph", "text": "Private payor coverage is almost non-existent, as they’re in on the joke. TransMedics is thus entirely a government pay scam - just like $10K toilet seats.", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:11.767+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "1d5866f1-26d5-433c-80b9-75481f0f0dbd", "parentComponentId": null }, { "bbox": { "h": 0.1, "w": 0.85, "x": 0.07, "y": 0.15 }, "kind": "paragraph", "text": "It exists solely as a creature of a preposterous Medicare reimbursement loophole unique to transplants – which regulators are racing to kill off, unbeknownst to bulls, taking TransMedics down with it.", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:11.767+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "e0f9eb3b-4c3d-42ca-86f0-f4cb895e1b6a", "parentComponentId": null }, { "bbox": { "h": 0.12, "w": 0.85, "x": 0.07, "y": 0.41 }, "kind": "quote", "text": "An ex-TransMedics reimbursement executive detailed the nuances: “the structure - it’s totally crazy...if they for pay for an OCS system on the NOP with the flight, all of these costs get paid at cost plus back to the hospital”; “Waleed will talk about it all the time...his investor calls...he will talk about how Medicare pays the cost...what are you guys worried about?”", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:11.767+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "874f3943-3207-47cd-ac4b-879ebf451e49", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "the structure – it’s totally crazy...if they for pay for an OCS system on the NOP with the flight, all of these costs get paid at cost plus back to the hospital; Waleed will talk about it all the time...his investor calls...he will talk about how Medicare pays the cost...what are you guys worried about? — Former executive in a key reimbursement role", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:45:55+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5372-7340-8f9a-7944dedf6c6c", "parentComponentId": null }, { "bbox": { "h": 0.03, "w": 0.3, "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:11.767+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "87f51b96-c9b5-4341-88d6-6f71c94ad218", "parentComponentId": null }, { "bbox": { "h": 0.08, "w": 0.85, "x": 0.07, "y": 0.07 }, "kind": "title", "text": "Perverse incentives are central to understanding TransMedics business model.", "attrs": null, "canon": { "kind": { "name": "Title", "slug": "title", "status": "active", "canonId": "019de52c-f7dd-76d9-b848-b1f12bd85cf4", "version": 1, "description": "Slide title or headline." }, "tool": null, "subkind": { "name": "Headline", "slug": "headline", "status": "active", "canonId": "019de52c-fae1-7463-9a7c-d60668eced0d", "version": 1, "description": null }, "framework": null }, "subkind": "headline", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:11.767+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "982adccf-b075-4868-a2f7-0a2d54b07043", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [ { "matchId": "81ca706a-0a78-4c78-8899-9d9eed426925", "evidence": "The slide frames the business model as a 'government pay scam' and 'loophole' to be exposed.", "framework": null, "confidence": 0.9, "extraction": { "at": "2026-05-02 20:12:11.767+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 25, "frameworkName": "fraud-exposure" } ], "arcBeats": [ { "to": 30, "arc": { "name": "Overcoming the Monster", "slug": "overcoming-monster", "status": "active", "bestFor": "Competitive positioning, rallying teams", "canonId": "019dd956-6339-76ac-9cbf-4b377c3aa89e", "version": 1, "bodyDocId": "019df22a-2356-73eb-8061-d8c81dc0aa49", "structure": "The Monster -> The Call -> The Struggle -> The Victory -> The New Order", "description": null, "familyLabel": null }, "from": 12, "name": "Exposure of Contradictions", "beatId": "072007ec-5fd3-4416-b852-0e181a364efd", "matchId": "d22e2123-5207-45f3-8f91-8fe159736ca7", "beatType": null, "evidence": "The section highlights contradictions in TransMedics Group Inc.'s statements and actions.", "position": 1, "isPrimaryArc": true, "parentBeatType": null, "alignedBlockIds": null, "matchConfidence": 0.8 } ], "loops": [], "locked": true }, { "page": 26, "type": "tension", "title": "Uses direct quotes from industry experts to build a case of systemic exploitation.", "function": "expose_contradiction", "rawType": "expose_contradiction", "block": null, "metadata": { "slideType": "expose_contradiction", "slideTypeCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-124c-75aa-984a-0a3d0d8fc8df", "version": 1, "description": null }, "function": "expose_contradiction", "functionCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-171f-776f-887c-73edaff4cf9c", "version": 1, "description": null }, "density": "overcrowded", "densityScore": 85, "componentCount": 10, "textChars": 3921, "nDataPoints": 0, "notes": "Uses direct quotes from industry experts to build a case of systemic exploitation.", "elementsJson": [ "paragraph", "quote_block" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:12:05.406+00", "seconds": 9.321, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/26", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-26", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "With no reimbursement limit, TransMedics has free reign for price gouging – and transplant centers just pass it on to the taxpayer.", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:45:54+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5372-7340-8f99-e732a5607a25", "parentComponentId": null }, { "bbox": { "h": 0.08, "w": 0.86, "x": 0.07, "y": 0.27 }, "kind": "paragraph", "text": "An executive at a major Organ Procurement Organization (OPO) – we shortly explain the structure of the US transplant system – called the “organ acquisition charge...a gray area...the same is true for TransMedics...you could exploit any charge...you can exploit the types of planes....you can exploit the surgeon fees...all of those things can be inflated.”", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:05.406+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "30d0f538-2c5d-4629-b137-de2919dfef1f", "parentComponentId": null }, { "bbox": { "h": 0.02, "w": 0.86, "x": 0.07, "y": 0.65 }, "kind": "paragraph", "text": "Organ acquisition cost is a “gray area”; ‘you could exploit any charge that they had’", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:05.406+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "3e76e356-749c-4c37-9e02-524c51634bee", "parentComponentId": null }, { "bbox": { "h": 0.08, "w": 0.86, "x": 0.07, "y": 0.19 }, "kind": "paragraph", "text": "A surgeon who leads a large academic transplant center: “Medicare because they’re so frickin’ stupid as a government bureaucracy...they have not put a cap...if TransMedics charged $200,000 for the kit, I would be able to get reimbursed.”", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:05.406+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "3f957cc0-58d6-4969-acad-9610da9fba6f", "parentComponentId": null }, { "bbox": { "h": 0.02, "w": 0.86, "x": 0.07, "y": 0.41 }, "kind": "paragraph", "text": "Medicare is “so frickin’ stupid” to reimburse via Medicare Cost Report; no cap on TransMedics cost", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:05.406+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "ebb7ce6d-e902-4b19-8b41-4dda4852e796", "parentComponentId": null }, { "bbox": { "h": 0.25, "w": 0.86, "x": 0.07, "y": 0.67 }, "kind": "quote", "text": "“The organ acquisition charge itself is a gray area...the same is true for TransMedics...there is really a lot of latitude with what they’re charging, and there’s no standardization. So, when TransMedics comes in and says, look, you’ve got to use our guys, use our recovery surgeons - they just set that fee. And the OPO’s have to pay it and pass it through their transplant center...there is the opportunity to take advantage of that...You could exploit any charge that they had. You can exploit the types of planes that you use. You can exploit the surgeon fees. You can expense the pump time, the supply cost, transport cost—all of those things can be inflated. And so, I used to pay the helicopters and the jets for all transplants. And we had an airport that was 12 miles away. By ambulance, it took 10 minutes, and by helicopter, it took 7. And they would require a helicopter that costs $11,000 versus an ambulance that costs $1200. An ambulance going a short distance was $400. If they turned the siren on, it was $900. Same distance..” – Longtime executive at major OPO (organ procurement organization), and on UNOS committees", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Pull quote", "slug": "pull-quote", "status": "active", "canonId": "019de52c-fbf9-76fe-97e1-a0b7540445c9", "version": 1, "description": null }, "framework": null }, "subkind": "pull-quote", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:05.406+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "00915e05-833b-4147-819f-37040becce35", "parentComponentId": null }, { "bbox": { "h": 0.21, "w": 0.86, "x": 0.07, "y": 0.43 }, "kind": "quote", "text": "“I’ve served on medtech panels. And I’ve been extremely critical. Medicare, because they’re so frickin’ stupid as a government bureaucracy, they’re reimbursing transplant centers through their Medicare Cost Report...at some point, Medicare is going to, once there are other FDA-approved devices, say no, we’re not paying $100,000 for you guys to provide the surgeon, the aviation company, and the device and the technicians...say my total costs were $10 million and I did 40% of those transplants were Medicare patients. I would get $4 million back from Medicare because that’s 40% of the charges that I had. What Medicare has not done so far is they have not put a cap on the amount of money per procedure that you’re doing. Theoretically, if TransMedics charged $200,000 for the kit,, I would be able to get that reimbursed right now because Medicare is so stupid that they’re not restricting it like other companies do like private insurers do. – Prominent surgeon, Director of leading West Coast academic transplant center", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Pull quote", "slug": "pull-quote", "status": "active", "canonId": "019de52c-fbf9-76fe-97e1-a0b7540445c9", "version": 1, "description": null }, "framework": null }, "subkind": "pull-quote", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:05.406+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "ce30587e-1653-4d09-80e8-1b3bbdc5a45b", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "Medicare because they're so frickin' stupid as a government bureaucracy...they have not put a cap...if TransMedics charged $200,000 for the kit, I would be able to get reimbursed. — Prominent surgeon, Director of leading West Coast academic transplant center. The organ acquisition charge itself is a gray area...the same is true for TransMedics...You could exploit any charge that they had. You can exploit the types of planes that you use. You can exploit the surgeon fees. You can expense the pump time, the supply cost, transport cost—all of those things can be inflated. — Longtime executive at major OPO (organ procurement organization), and on UNOS committees", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:45:54+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5372-7340-8f99-e8e24575b65e", "parentComponentId": null }, { "bbox": { "h": 0.02, "w": 0.3, "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:05.406+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "2f4e3936-9ccd-43b5-9391-378829989620", "parentComponentId": null }, { "bbox": { "h": 0.12, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "title", "text": "With no reimbursement limit, TransMedics has free reign for price gouging – and transplant centers just pass it on to the taxpayer.", "attrs": null, "canon": { "kind": { "name": "Title", "slug": "title", "status": "active", "canonId": "019de52c-f7dd-76d9-b848-b1f12bd85cf4", "version": 1, "description": "Slide title or headline." }, "tool": null, "subkind": { "name": "Headline", "slug": "headline", "status": "active", "canonId": "019de52c-fae1-7463-9a7c-d60668eced0d", "version": 1, "description": null }, "framework": null }, "subkind": "headline", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:05.406+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "81d0877f-1c58-4473-8e97-d910da1d0530", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [], "arcBeats": [ { "to": 30, "arc": { "name": "Overcoming the Monster", "slug": "overcoming-monster", "status": "active", "bestFor": "Competitive positioning, rallying teams", "canonId": "019dd956-6339-76ac-9cbf-4b377c3aa89e", "version": 1, "bodyDocId": "019df22a-2356-73eb-8061-d8c81dc0aa49", "structure": "The Monster -> The Call -> The Struggle -> The Victory -> The New Order", "description": null, "familyLabel": null }, "from": 12, "name": "Exposure of Contradictions", "beatId": "072007ec-5fd3-4416-b852-0e181a364efd", "matchId": "d22e2123-5207-45f3-8f91-8fe159736ca7", "beatType": null, "evidence": "The section highlights contradictions in TransMedics Group Inc.'s statements and actions.", "position": 1, "isPrimaryArc": true, "parentBeatType": null, "alignedBlockIds": null, "matchConfidence": 0.8 } ], "loops": [], "locked": true }, { "page": 27, "type": "tension", "title": "The slide uses a combination of investigative journalism style text and corporate marketing materials to expose a perceived conflict of interest.", "function": "name_villain", "rawType": "villain_critique", "block": null, "metadata": { "slideType": "villain_critique", "slideTypeCanon": { "name": "Villain critique", "slug": "villain_critique", "status": "active", "canonId": "019de52d-10bc-7136-bf20-09de59d17447", "version": 1, "description": null }, "function": "name_villain", "functionCanon": { "name": "Name villain", "slug": "name_villain", "status": "active", "canonId": "019de52d-1746-70d6-bc58-5eeaf5865526", "version": 1, "description": null }, "density": "balanced", "densityScore": 49, "componentCount": 7, "textChars": 992, "nDataPoints": 1, "notes": "The slide uses a combination of investigative journalism style text and corporate marketing materials to expose a perceived conflict of interest.", "elementsJson": [ "paragraph", "map", "screenshot", "icon_grid" ], "confidence": 0.95, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:12:03.697+00", "seconds": 7.544, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/27", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-27", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "The move was a bait-and-switch. As alleged by Congressman Gosar and confirmed by numerous transplant centers we interviewed, TransMedics would no longer train hospital staff to use their device, forcing them to pay for its dedicated device technicians, surgeons, and aircraft.", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:45:55+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5372-7340-8f9a-8a88a4bd5b35", "parentComponentId": null }, { "bbox": { "h": 0.28, "w": 0.42, "x": 0.51, "y": 0.62 }, "kind": "image", "text": "National OCS Program integrated network graphic", "attrs": null, "canon": { "kind": { "name": "Image", "slug": "image", "status": "active", "canonId": "019de52c-f978-701f-a720-51d029d769e7", "version": 1, "description": "Photo, illustration, screenshot or icon." }, "tool": null, "subkind": { "name": "Infographic", "slug": "infographic", "status": "active", "canonId": "019de52c-fe26-750c-9d7d-9f34e21324e8", "version": 1, "description": null }, "framework": null }, "subkind": "infographic", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:03.697+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "c42bfbda-5dd5-488a-a776-1cee31deaf6c", "parentComponentId": null }, { "bbox": { "h": 0.28, "w": 0.42, "x": 0.07, "y": 0.62 }, "kind": "image", "text": "Map of US with NOP hubs", "attrs": null, "canon": { "kind": { "name": "Image", "slug": "image", "status": "active", "canonId": "019de52c-f978-701f-a720-51d029d769e7", "version": 1, "description": "Photo, illustration, screenshot or icon." }, "tool": null, "subkind": { "name": "Map", "slug": "map", "status": "active", "canonId": "019de52c-fe4d-77bd-b0a4-d72d58b9e5a4", "version": 1, "description": null }, "framework": null }, "subkind": "map", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:03.697+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "ba63cada-57f4-4eb7-898c-f0e97648f179", "parentComponentId": null }, { "bbox": { "h": 0.42, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "paragraph", "text": "If Medicare will reimburse any and all organ acquisition charges, and you’re already selling $70-90K disposable kits for your rig, why not look for other ways to run up the tab? TransMedics thus rolled out its National OCS Program (“NOP”) in 2022...", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:03.697+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "cfe5bb38-9172-418c-82df-e25ae9ab0fb0", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "This is a fact of organ transplant. All aviation and logistics transport are fully reimbursed through the same mechanism of organ acquisition...there’s no limit...there is no limit. — CEO of TransMedics (2023 call)", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:45:55+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5372-7340-8f9a-8cd8a95a7294", "parentComponentId": null }, { "bbox": { "h": 0.02, "w": 0.55, "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts; TransMedics IR presentations https://investors.transmedics.com/", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:03.697+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "cfed9abc-4cc8-47de-9410-64d512fa4976", "parentComponentId": null }, { "bbox": { "h": 0.03, "w": 0.55, "x": 0.07, "y": 0.51 }, "kind": "title", "text": "TransMedics NOP service – excerpts from investor presentations", "attrs": null, "canon": { "kind": { "name": "Title", "slug": "title", "status": "active", "canonId": "019de52c-f7dd-76d9-b848-b1f12bd85cf4", "version": 1, "description": "Slide title or headline." }, "tool": null, "subkind": { "name": "Headline", "slug": "headline", "status": "active", "canonId": "019de52c-fae1-7463-9a7c-d60668eced0d", "version": 1, "description": null }, "framework": null }, "subkind": "headline", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:03.697+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "a45b044a-731d-46ba-8b3c-413f97ab8b15", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [ { "matchId": "feff230c-68b6-4e9c-9b43-652f2d15e42e", "evidence": "The slide explicitly frames TransMedics as a 'bait-and-switch' operator exploiting Medicare.", "framework": null, "confidence": 0.9, "extraction": { "at": "2026-05-02 20:12:03.697+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 27, "frameworkName": "antagonist-introduction" } ], "arcBeats": [ { "to": 30, "arc": { "name": "Overcoming the Monster", "slug": "overcoming-monster", "status": "active", "bestFor": "Competitive positioning, rallying teams", "canonId": "019dd956-6339-76ac-9cbf-4b377c3aa89e", "version": 1, "bodyDocId": "019df22a-2356-73eb-8061-d8c81dc0aa49", "structure": "The Monster -> The Call -> The Struggle -> The Victory -> The New Order", "description": null, "familyLabel": null }, "from": 12, "name": "Exposure of Contradictions", "beatId": "072007ec-5fd3-4416-b852-0e181a364efd", "matchId": "d22e2123-5207-45f3-8f91-8fe159736ca7", "beatType": null, "evidence": "The section highlights contradictions in TransMedics Group Inc.'s statements and actions.", "position": 1, "isPrimaryArc": true, "parentBeatType": null, "alignedBlockIds": null, "matchConfidence": 0.8 } ], "loops": [], "locked": true }, { "page": 28, "type": "tension", "title": "The slide uses a combination of anecdotal evidence from centers and financial logic to frame the company's business model as fraudulent.", "function": "expose_contradiction", "rawType": "expose_contradiction", "block": null, "metadata": { "slideType": "expose_contradiction", "slideTypeCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-124c-75aa-984a-0a3d0d8fc8df", "version": 1, "description": null }, "function": "expose_contradiction", "functionCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-171f-776f-887c-73edaff4cf9c", "version": 1, "description": null }, "density": "balanced", "densityScore": 44, "componentCount": 4, "textChars": 1422, "nDataPoints": 10, "notes": "The slide uses a combination of anecdotal evidence from centers and financial logic to frame the company's business model as fraudulent.", "elementsJson": [ "paragraph", "screenshot", "callout_box" ], "confidence": 0.95, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:12:05.563+00", "seconds": 9.135, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/28", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-28", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "The purpose of the jets, at face value, is disingenuous: the company is a one-trick pony in liver, with liver at 73% of total revenue in the most recent quarter.", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:45:55+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5372-7340-8f9a-60e1254ec64a", "parentComponentId": null }, { "bbox": { "h": 0.35, "w": 0.86, "x": 0.07, "y": 0.55 }, "kind": "image", "text": "TransMedics aircraft fleet -investor presentation, aircraft subsidiary website", "attrs": null, "canon": { "kind": { "name": "Image", "slug": "image", "status": "active", "canonId": "019de52c-f978-701f-a720-51d029d769e7", "version": 1, "description": "Photo, illustration, screenshot or icon." }, "tool": null, "subkind": { "name": "Infographic", "slug": "infographic", "status": "active", "canonId": "019de52c-fe26-750c-9d7d-9f34e21324e8", "version": 1, "description": null }, "framework": null }, "subkind": "infographic", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:05.563+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "5ac8989d-5333-4fc3-a9de-9503a664b068", "parentComponentId": null }, { "bbox": { "h": 0.45, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "paragraph", "text": "TransMedics went full bling with what appear to be 18 Embraer Phenom 300 jets, which seat 11 with a 2,000 mile range – naturally, as one can jam Medicare with a far higher hourly rate with a $13MM jet than, for example, a PC-12 with similar range at 10-15% of the cost, typical of organ transport services. NOP fees can run $25K-$100K per case, plus a $70-90K disposable, per CEO Q&A on a call. Centers told us they’ve been billed $300k-$400K without explanation. The purpose of the jets, at face value, is disingenuous: the company is a one-trick pony in liver, with liver at 73% of total revenue in the most recent quarter. Given the way the national organ allocation system works, livers rarely travel far. Various centers told us that 100% of their liver transplants involve a donor and recipient within a driving radius of 250 miles, as we detail in chapter 6. Thus, no jets are necessary, and neither is a device to enable extended transportation times – making it obvious that TMDX is just a Medicare rig.", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:05.563+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "ee4928d1-2669-48d0-8149-6d4b895886b4", "parentComponentId": null }, { "bbox": { "h": 0.03, "w": 0.86, "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts; TransMedics IR presentations https://investors.transmedics.com/; https://flysummit.com/careers/phenom-300-captain", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:05.563+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "3b8bc841-9c9e-47ff-94d8-d38faaba722b", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [ { "matchId": "6fb10e6b-ef12-43f6-ad43-22ff9e026724", "evidence": "The slide explicitly frames the company's business model as a 'Medicare rig' and 'disingenuous' to expose potential financial misconduct.", "framework": null, "confidence": 0.9, "extraction": { "at": "2026-05-02 20:12:05.563+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 28, "frameworkName": "fraud-exposure" } ], "arcBeats": [ { "to": 30, "arc": { "name": "Overcoming the Monster", "slug": "overcoming-monster", "status": "active", "bestFor": "Competitive positioning, rallying teams", "canonId": "019dd956-6339-76ac-9cbf-4b377c3aa89e", "version": 1, "bodyDocId": "019df22a-2356-73eb-8061-d8c81dc0aa49", "structure": "The Monster -> The Call -> The Struggle -> The Victory -> The New Order", "description": null, "familyLabel": null }, "from": 12, "name": "Exposure of Contradictions", "beatId": "072007ec-5fd3-4416-b852-0e181a364efd", "matchId": "d22e2123-5207-45f3-8f91-8fe159736ca7", "beatType": null, "evidence": "The section highlights contradictions in TransMedics Group Inc.'s statements and actions.", "position": 1, "isPrimaryArc": true, "parentBeatType": null, "alignedBlockIds": null, "matchConfidence": 0.8 } ], "loops": [], "locked": true }, { "page": 29, "type": "tension", "title": "The slide uses a Q&A format to highlight specific allegations from an industry executive regarding OIG, DOJ, and IRS involvement.", "function": "expose_contradiction", "rawType": "expose_contradiction", "block": null, "metadata": { "slideType": "expose_contradiction", "slideTypeCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-124c-75aa-984a-0a3d0d8fc8df", "version": 1, "description": null }, "function": "expose_contradiction", "functionCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-171f-776f-887c-73edaff4cf9c", "version": 1, "description": null }, "density": "dense", "densityScore": 71, "componentCount": 8, "textChars": 2934, "nDataPoints": 0, "notes": "The slide uses a Q&A format to highlight specific allegations from an industry executive regarding OIG, DOJ, and IRS involvement.", "elementsJson": [ "paragraph", "quote_block", "footnote" ], "confidence": 0.95, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:12:05.337+00", "seconds": 8.907, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/29", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-29", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "In reality, the abuses it has spawned are too extreme to avoid scrutiny.", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-23 01:18:10+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-70f3-714d-84bf-2475d13c32fe", "parentComponentId": null }, { "bbox": { "h": 0.05, "w": 0.86, "x": 0.07, "y": 0.48 }, "kind": "list", "text": "Multiple regulatory and law enforcement agencies at a federal and state level allegedly investigating industry practices", "attrs": null, "canon": { "kind": { "name": "List", "slug": "list", "status": "active", "canonId": "019de52c-f94b-779b-a53b-fd4904a5f4d2", "version": 1, "description": "Bullet or numbered list." }, "tool": null, "subkind": { "name": "Bullet list", "slug": "bullet", "status": "active", "canonId": "019de52c-fc98-7169-a083-5cab805076ca", "version": 1, "description": null }, "framework": null }, "subkind": "bullet", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:05.337+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "109b6405-a306-4eb0-83e6-69454266d4ec", "parentComponentId": null }, { "bbox": { "h": 0.35, "w": 0.86, "x": 0.07, "y": 0.53 }, "kind": "paragraph", "text": "Q: “A surgeon I just talked to said I’ll tell you who their whores are. He mentioned a couple of very high-volume users. It sounds to me like a bribery, pay-to-play kind of thing.”\nA: “There’s so much that’s going on to be found out. Do you know everything that’s going on with the OIG and DOJ and the IRS?”\nQ: “I read that Washington Post article.”\nA: “It’s deeper than that, and I’ll let you know because I’ve been interviewed for it.”\nQ: “Walk me through what you’re seeing. And how TransMedics may be a part of this stuff that the Washington Post is talking about as far as kickbacks.”\nA: “Here’s all the drama. I recently interviewed with the Department of Justice, the OIG, and the IRS. And with the DOJ out of Washington and out of New York, in particular. And then the state attorney general is getting involved in this as well because if there’s Medicare fraud, then there’s Medicaid fraud. And probably the most prominent attorney general that’s getting involved is Virginia, and the reason why that’s important is because UNOS is there, and so is A-OPO, which is the OPO governing body, not a governing body but a trade association, and they also have a terrible OPO based there.”– CEO of a major OPO (Organ Procurement Organization), longtime industry executive", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:05.337+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "e2a10010-7115-41e8-aba5-34d9f518d5a2", "parentComponentId": null }, { "bbox": { "h": 0.12, "w": 0.86, "x": 0.07, "y": 0.19 }, "kind": "paragraph", "text": "In reality, the abuses it has spawned are too extreme to avoid scrutiny. We spoke with the CEO of major organ procurement organization, who shared color about an unfolding investigation into the industry's practices, and who implied that TransMedics is at risk.", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:05.337+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "e6d609cb-20b1-44f1-b6f0-0614d66ff33a", "parentComponentId": null }, { "bbox": { "h": 0.15, "w": 0.86, "x": 0.07, "y": 0.31 }, "kind": "quote", "text": "“there’s so much that’s going on to be found out...do you know everything that’s going on with the OIG and DOJ and the IRS...it’s deeper than [the Washington Post]...here’s the drama...I recently interviewed with the Department of Justice, the OIG, and the IRS...and with the DOJ out of Washington and out of New York, in particular...and then the state attorney general...Medicare fraud...the most prominent attorney general that’s getting involved is Virginia....”", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:05.337+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "a2e064f0-a2a0-43b9-9f92-3e404daaf5c5", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "“There’s so much that’s going on to be found out...do you know everything that’s going on with the OIG and DOJ and the IRS...it’s deeper than [the Washington Post]...here’s the drama...I recently interviewed with the Department of Justice, the OIG, and the IRS...and with the DOJ out of Washington and out of New York, in particular...and then the state attorney general...Medicare fraud...the most prominent attorney general that’s getting involved is Virginia....” — CEO of a major OPO (Organ Procurement Organization), longtime industry executive", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-23 01:18:10+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-70f3-714d-84bf-2a82b1922d37", "parentComponentId": null }, { "bbox": { "h": 0.02, "w": 0.3, "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:05.337+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "0a97463a-b164-43b6-beeb-69214f1dcaa6", "parentComponentId": null }, { "bbox": { "h": 0.12, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "title", "text": "The TransMedics bull case boils down to a simple hope: that the Medicare organ acquisition charge boondoggle continues - into perpetuity.", "attrs": null, "canon": { "kind": { "name": "Title", "slug": "title", "status": "active", "canonId": "019de52c-f7dd-76d9-b848-b1f12bd85cf4", "version": 1, "description": "Slide title or headline." }, "tool": null, "subkind": { "name": "Headline", "slug": "headline", "status": "active", "canonId": "019de52c-fae1-7463-9a7c-d60668eced0d", "version": 1, "description": null }, "framework": null }, "subkind": "headline", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:05.337+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "da827cf3-e526-4434-a6ac-d49e4ada2a42", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [ { "matchId": "3ed6fbda-0191-4e03-baeb-d34307a283c6", "evidence": "The slide explicitly frames the company's business model as a 'boondoggle' and cites expert testimony regarding DOJ/OIG investigations into fraud and bribery.", "framework": null, "confidence": 0.9, "extraction": { "at": "2026-05-02 20:12:05.337+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 29, "frameworkName": "fraud-exposure" } ], "arcBeats": [ { "to": 30, "arc": { "name": "Overcoming the Monster", "slug": "overcoming-monster", "status": "active", "bestFor": "Competitive positioning, rallying teams", "canonId": "019dd956-6339-76ac-9cbf-4b377c3aa89e", "version": 1, "bodyDocId": "019df22a-2356-73eb-8061-d8c81dc0aa49", "structure": "The Monster -> The Call -> The Struggle -> The Victory -> The New Order", "description": null, "familyLabel": null }, "from": 12, "name": "Exposure of Contradictions", "beatId": "072007ec-5fd3-4416-b852-0e181a364efd", "matchId": "d22e2123-5207-45f3-8f91-8fe159736ca7", "beatType": null, "evidence": "The section highlights contradictions in TransMedics Group Inc.'s statements and actions.", "position": 1, "isPrimaryArc": true, "parentBeatType": null, "alignedBlockIds": null, "matchConfidence": 0.8 } ], "loops": [], "locked": true }, { "page": 30, "type": "tension", "title": "The slide uses highlighted text to emphasize key quotes from an industry executive regarding systemic abuse of the cost-based reimbursement model.", "function": "expose_contradiction", "rawType": "ceo_quote", "block": null, "metadata": { "slideType": "ceo_quote", "slideTypeCanon": { "name": "CEO quote", "slug": "ceo_quote", "status": "active", "canonId": "019de52d-09b6-71c8-93a5-f90a9772a8fa", "version": 1, "description": null }, "function": "expose_contradiction", "functionCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-171f-776f-887c-73edaff4cf9c", "version": 1, "description": null }, "density": "dense", "densityScore": 53, "componentCount": 7, "textChars": 1410, "nDataPoints": 0, "notes": "The slide uses highlighted text to emphasize key quotes from an industry executive regarding systemic abuse of the cost-based reimbursement model.", "elementsJson": [ "paragraph", "quote_block", "footnote" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:12:04.51+00", "seconds": 7.808, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/30", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-30", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "OIG investigating every key transplant center and OPO's as part of investigation into overcharging via Cost Report", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:45:58+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a974-483fa3b818fa", "parentComponentId": null }, { "bbox": { "h": 0.15, "w": 0.86, "x": 0.07, "y": 0.22 }, "kind": "paragraph", "text": "He stated that regulators will, for the first time, define \"reasonable cost\" and close the loophole – perhaps a 2025 event: \"they're going to investigate every single OPO...every single transplant program\"; \"their investigation has to do with the Cost Report...how we're reimbursed...overcharging the whole time...there just hasn't been any oversight on it...things are changing so fast...they're going to come out and fix things...absolutely, it's been getting abused...the government is going to come down, and they're doing to start setting what's reasonable cost.\"", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:04.51+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "89e22d8e-4c71-42cd-af88-f458d5a16e78", "parentComponentId": null }, { "bbox": { "h": 0.15, "w": 0.86, "x": 0.07, "y": 0.41 }, "kind": "quote", "text": "OIG investigating every key transplant center and OPO's as part of investigation into overcharging via Cost Report", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:04.51+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "9e582ee0-9a25-4aaf-b86f-44f93e90e595", "parentComponentId": null }, { "bbox": { "h": 0.25, "w": 0.86, "x": 0.07, "y": 0.66 }, "kind": "quote", "text": "No oversight of \"reasonable cost\" cost bucket; \"getting abused\" and regulators will fix", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:04.51+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "bee211c0-cd44-42c8-868d-0570af6393e9", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "“OIG recently announced that they’re going to investigate every single OPO, and they’re going to investigate every single transplant program, and it’s going to happen by the end of 2025... I’ve been overcharging the whole time.” — CEO of a major OPO (Organ Procurement Organization), longtime industry executive", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:45:58+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a974-4c3aa12d7c46", "parentComponentId": null }, { "bbox": { "h": 0.03, "w": 0.3, "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:04.51+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "83f65da1-bc4a-421a-9981-6be1e58f6d07", "parentComponentId": null }, { "bbox": { "h": 0.15, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "title", "text": "The OPO CEO indicated a parallel investigation by the OIG, separate from the DOJ, focused on the Cost Report, the loophole at the center of TransMedics pricing.", "attrs": null, "canon": { "kind": { "name": "Title", "slug": "title", "status": "active", "canonId": "019de52c-f7dd-76d9-b848-b1f12bd85cf4", "version": 1, "description": "Slide title or headline." }, "tool": null, "subkind": { "name": "Headline", "slug": "headline", "status": "active", "canonId": "019de52c-fae1-7463-9a7c-d60668eced0d", "version": 1, "description": null }, "framework": null }, "subkind": "headline", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:04.51+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "cbc55d4a-b22b-428e-9f74-520a6cfaa288", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [], "arcBeats": [ { "to": 30, "arc": { "name": "Overcoming the Monster", "slug": "overcoming-monster", "status": "active", "bestFor": "Competitive positioning, rallying teams", "canonId": "019dd956-6339-76ac-9cbf-4b377c3aa89e", "version": 1, "bodyDocId": "019df22a-2356-73eb-8061-d8c81dc0aa49", "structure": "The Monster -> The Call -> The Struggle -> The Victory -> The New Order", "description": null, "familyLabel": null }, "from": 12, "name": "Exposure of Contradictions", "beatId": "072007ec-5fd3-4416-b852-0e181a364efd", "matchId": "d22e2123-5207-45f3-8f91-8fe159736ca7", "beatType": null, "evidence": "The section highlights contradictions in TransMedics Group Inc.'s statements and actions.", "position": 1, "isPrimaryArc": true, "parentBeatType": null, "alignedBlockIds": null, "matchConfidence": 0.8 } ], "loops": [], "locked": true }, { "page": 31, "type": "tension", "title": "The slide uses direct quotes from an industry executive to build a bearish case against TransMedics.", "function": "expose_contradiction", "rawType": "expose_contradiction", "block": null, "metadata": { "slideType": "expose_contradiction", "slideTypeCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-124c-75aa-984a-0a3d0d8fc8df", "version": 1, "description": null }, "function": "expose_contradiction", "functionCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-171f-776f-887c-73edaff4cf9c", "version": 1, "description": null }, "density": "overcrowded", "densityScore": 83, "componentCount": 9, "textChars": 3131, "nDataPoints": 2, "notes": "The slide uses direct quotes from an industry executive to build a bearish case against TransMedics.", "elementsJson": [ "paragraph", "quote_block", "footnote" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:12:05.05+00", "seconds": 8.327, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/31", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-31", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": { "h": 0.03, "w": 0.6, "x": 0.07, "y": 0.44 }, "kind": "callout", "text": "Regulators about to crack down on the TransMedics gravy train by enforcing “reasonable cost”", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": null, "subkind": { "name": "Primary callout", "slug": "primary", "status": "active", "canonId": "019de52c-fbd1-70eb-a9ce-8997f8674c1d", "version": 1, "description": null }, "framework": null }, "subkind": "primary", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:05.05+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "0ea6a07a-d1d9-4c68-ba3e-50f27c6ee73a", "parentComponentId": null }, { "bbox": { "h": 0.03, "w": 0.6, "x": 0.07, "y": 0.62 }, "kind": "callout", "text": "Regulators about to crack down on the TransMedics gravy train by enforcing “reasonable cost”", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": null, "subkind": { "name": "Primary callout", "slug": "primary", "status": "active", "canonId": "019de52c-fbd1-70eb-a9ce-8997f8674c1d", "version": 1, "description": null }, "framework": null }, "subkind": "primary", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:05.05+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "62588043-7893-4a7e-83cd-188fa5bb8167", "parentComponentId": null }, { "bbox": null, "kind": "callout", "text": "I think the government is working their way down. Because what CMS does is like, what’s a reasonable cost? Well, this stuff is all new, so they’ve never established what reasonable costs are. I think what they’re going to do is I think they’re going to come in and they’re going to establish ‘reasonable cost.’ And now, all of a sudden, the Hawker 800 that costs $12 million does not make sense because that’s not reasonable cost.", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-23 01:18:10+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-70f3-714d-84bf-3c55e11e73c5", "parentComponentId": null }, { "bbox": { "h": 0.25, "w": 0.86, "x": 0.07, "y": 0.15 }, "kind": "paragraph", "text": "calling it out as a creature of a perverse reimbursement rule, stating that regulators are locked in and ready to blow up its gravy train - “the glory days of we’re going to charge $100,000 for a TransMedics device, and you have to use our people and...our expensive jet - I think all that is over...I think the gravy train is coming to an end, honestly”; “they’re going to come in because everything in transplant is based on what’s a reasonable cost...the government is working their way down...this stuff is all new...they’ve never established what reasonable costs are...they’re going to come in an establish ‘reasonable cost’...and now, all of a sudden, the Hawker 800 that costs $12 million does not make sense anymore because that’s not reasonable cost.”", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:05.05+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "308a124e-f38b-4638-836f-25a1a9b7c2ad", "parentComponentId": null }, { "bbox": { "h": 0.08, "w": 0.86, "x": 0.07, "y": 0.48 }, "kind": "quote", "text": "“So, I really think the government is going to come in, and they’re really going to shake this up, and I think the glory days of we’re going to charge $100,000 for a TransMedics device, and you have to use our people, and you’ve got to use our expensive jet - I think all that is over. I think the gravy train is coming to an end, honestly. I think the government is going to really come in.” - CEO of a major OPO (Organ Procurement Organization), longtime industry executive", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:05.05+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "62a43cf0-2264-4395-8ed0-77f8bc4df5a6", "parentComponentId": null }, { "bbox": { "h": 0.22, "w": 0.86, "x": 0.07, "y": 0.66 }, "kind": "quote", "text": "Q: “So, you think the government is going to wipe out TransMedics’ gravy train?” A: “I think so. I think they’re going to come in because everything in transplant is based on what’s a reasonable cost... I think the government is working their way down. Because what CMS does is like, what’s a reasonable cost? Well, this stuff is all new, so they’ve never established what reasonable costs are. I think what they’re going to do is I think they’re going to come in and they’re going to establish “reasonable cost.” And now, all of a sudden, the Hawker 800 that costs $12 million does not make sense because that’s not reasonable cost.” - CEO of a major OPO (Organ Procurement Organization), longtime industry executive", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:05.05+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "7697cd7b-c446-4d00-bdca-0645c6b531a7", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "“So, I really think the government is going to come in, and they’re really going to shake this up, and I think the glory days of we’re going to charge $100,000 for a TransMedics device, and you have to use our people, and you’ve got to use our expensive jet - I think all that is over. I think the gravy train is coming to an end, honestly.” — CEO of a major OPO (Organ Procurement Organization), longtime industry executive", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-23 01:18:10+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-70f3-714d-84bf-416111e55b4b", "parentComponentId": null }, { "bbox": { "h": 0.02, "w": 0.3, "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:05.05+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "ff7a1f8d-e83a-44bc-8374-88b07b695a73", "parentComponentId": null }, { "bbox": { "h": 0.08, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "title", "text": "He emphasized the exploitation of “Reasonable Cost” as the heart of TransMedics scam", "attrs": null, "canon": { "kind": { "name": "Title", "slug": "title", "status": "active", "canonId": "019de52c-f7dd-76d9-b848-b1f12bd85cf4", "version": 1, "description": "Slide title or headline." }, "tool": null, "subkind": { "name": "Headline", "slug": "headline", "status": "active", "canonId": "019de52c-fae1-7463-9a7c-d60668eced0d", "version": 1, "description": null }, "framework": null }, "subkind": "headline", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:05.05+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "0ce868e7-7949-43cf-9283-d8a7a1e1e24d", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [], "arcBeats": [], "loops": [], "locked": true }, { "page": 32, "type": "tension", "title": "The slide uses a Q&A transcript format to build a narrative about an ongoing investigative report.", "function": "expose_contradiction", "rawType": "expose_contradiction", "block": null, "metadata": { "slideType": "expose_contradiction", "slideTypeCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-124c-75aa-984a-0a3d0d8fc8df", "version": 1, "description": null }, "function": "expose_contradiction", "functionCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-171f-776f-887c-73edaff4cf9c", "version": 1, "description": null }, "density": "dense", "densityScore": 55, "componentCount": 6, "textChars": 3032, "nDataPoints": 0, "notes": "The slide uses a Q&A transcript format to build a narrative about an ongoing investigative report.", "elementsJson": [ "paragraph", "quote_block", "footnote" ], "confidence": 0.95, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:12:04.671+00", "seconds": 7.879, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/32", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-32", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "I heard that the Washington Post is working on a report because there is some concern that companies are giving kickbacks to some surgeons or hospitals for using the machine.", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:45:56+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5372-7340-8f9a-a90c84fff503", "parentComponentId": null }, { "bbox": { "h": 0.25, "w": 0.86, "x": 0.07, "y": 0.65 }, "kind": "list", "text": "Washington Post reporter allegedly reached out to surgeons regarding alleged kickbacks from TransMedics\nA: “I heard a little rumor, but again, this is rumor, okay? I heard that the Washington Post is working on a report because there is some concern that companies are giving kickbacks to some surgeons or hospitals for using the machine.”\nQ: “I saw that article. But that was talking about OPO’s. Was that talking about TransMedics—they didn’t mention TransMedics.”\nA: “No, no, no. This is something that is not published. I heard that there is a reporter working on TransMedics, specifically. This is not about OPO’s”\nQ: “You heard the Washington Post is working on TransMedics getting kickbacks?”\nA: “Yeah, that’s what I heard. But again, this is just a rumor that I heard from some people, that they are working on a report.”\nQ: “When did you hear this about the “Washington Post?”\nA: “I heard that a few months ago. The Washington Post was reaching out to some transplant surgeons across the country, like a very renowned transplant surgeon; I know that a reporter was reaching out to a surgeon because they were working on a report.” - Transplant surgeon and division chief of the liver program at a world-renowned academic center", "attrs": null, "canon": { "kind": { "name": "List", "slug": "list", "status": "active", "canonId": "019de52c-f94b-779b-a53b-fd4904a5f4d2", "version": 1, "description": "Bullet or numbered list." }, "tool": null, "subkind": { "name": "Bullet list", "slug": "bullet", "status": "active", "canonId": "019de52c-fc98-7169-a083-5cab805076ca", "version": 1, "description": null }, "framework": null }, "subkind": "bullet", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:04.671+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "1762bc99-34b9-4c97-91bc-b115e3182646", "parentComponentId": null }, { "bbox": { "h": 0.45, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "paragraph", "text": "In Feb 2024, the Washington Post broke the news of a “wide-ranging federal investigation” involving “US attorneys in various parts of the country” – the one for which, we assume, the OPO executive was interrogated. The authorities raided the homes of ten CEO’s of Organ Procurement Organizations, known as OPO’s. A surgeon at a pre-eminent center told us that the Post may now be working on a story about TransMedics, stating that they have been “reaching out to some transplant surgeons across the country, like a very prominent surgeon...I know that a reporter was reaching out to a surgeon because they were working on a report.” We suspect the surgeon spoke with the reporter, given his stature in the field: “I heard that the Washington Post is working on a report because there is some concern that companies are giving kickbacks to some surgeons or hospitals for using the machine”; “this is something that is not published...I heard that there is a reporter working on TransMedics, specifically.”", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:04.671+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "fa64cc61-96e4-4990-a789-06d3b038b6f7", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "I heard that the Washington Post is working on a report because there is some concern that companies are giving kickbacks to some surgeons or hospitals for using the machine; this is something that is not published...I heard that there is a reporter working on TransMedics, specifically. — Transplant surgeon and division chief of the liver program at a world-renowned academic center", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:45:56+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5372-7340-8f9a-ae691859da00", "parentComponentId": null }, { "bbox": { "h": 0.03, "w": 0.6, "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts; https://www.washingtonpost.com/health/2024/02/26/organ-transplant-investigation/", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:04.671+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "b0046195-5efe-4111-8ffb-1827b1e1c54c", "parentComponentId": null }, { "bbox": { "h": 0.08, "w": 0.6, "x": 0.07, "y": 0.54 }, "kind": "title", "text": "Washington Post, Feb 26, 2024\nU.S. launches probe into possible fraud by organ collection groups", "attrs": null, "canon": { "kind": { "name": "Title", "slug": "title", "status": "active", "canonId": "019de52c-f7dd-76d9-b848-b1f12bd85cf4", "version": 1, "description": "Slide title or headline." }, "tool": null, "subkind": { "name": "Headline", "slug": "headline", "status": "active", "canonId": "019de52c-fae1-7463-9a7c-d60668eced0d", "version": 1, "description": null }, "framework": null }, "subkind": "headline", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:04.671+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "82bc85d7-9762-4513-864c-75993182e488", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [ { "matchId": "6a050a73-0514-4d37-9595-2f5d3bb78c79", "evidence": "The slide explicitly frames the investigation as a potential fraud case involving kickbacks.", "framework": null, "confidence": 0.8, "extraction": { "at": "2026-05-02 20:12:04.671+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 32, "frameworkName": "fraud-exposure" } ], "arcBeats": [], "loops": [], "locked": true }, { "page": 33, "type": "tension", "title": "The slide uses a Q&A format to highlight potential financial incentives and investigative scrutiny regarding TransMedics.", "function": "expose_contradiction", "rawType": "expose_contradiction", "block": null, "metadata": { "slideType": "expose_contradiction", "slideTypeCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-124c-75aa-984a-0a3d0d8fc8df", "version": 1, "description": null }, "function": "expose_contradiction", "functionCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-171f-776f-887c-73edaff4cf9c", "version": 1, "description": null }, "density": "balanced", "densityScore": 31, "componentCount": 5, "textChars": 969, "nDataPoints": 0, "notes": "The slide uses a Q&A format to highlight potential financial incentives and investigative scrutiny regarding TransMedics.", "elementsJson": [ "paragraph", "quote_block" ], "confidence": 0.9, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:12:04.001+00", "seconds": 7.186, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/33", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-33", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "That something “big” may drop seems to be an open secret – transplant surgery is a small field with only 400 surgeons in the US for liver and ~50-80 responsible for the vast majority, and even fewer for heart and lung.", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:45:55+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5372-7340-8f9a-4c16c05d2ddb", "parentComponentId": null }, { "bbox": { "h": 0.35, "w": 0.86, "x": 0.07, "y": 0.58 }, "kind": "list", "text": "Washington Post reporter allegedly reached out to surgeons regarding alleged kickbacks from TransMedics", "attrs": null, "canon": { "kind": { "name": "List", "slug": "list", "status": "active", "canonId": "019de52c-f94b-779b-a53b-fd4904a5f4d2", "version": 1, "description": "Bullet or numbered list." }, "tool": null, "subkind": { "name": "Bullet list", "slug": "bullet", "status": "active", "canonId": "019de52c-fc98-7169-a083-5cab805076ca", "version": 1, "description": null }, "framework": null }, "subkind": "bullet", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:04.001+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "a6abb192-babf-4bc1-8f0c-e971ebc1e59f", "parentComponentId": null }, { "bbox": { "h": 0.45, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "paragraph", "text": "The surgeon indicated the Washington Post inquiries were recent, and while oblique, provided specifics about the reporter’s line of questioning that lend credibility...", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:04.001+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "010eee35-5282-4f2c-8ef2-381d939d22d8", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "“because everybody is like, how is it possible that some of these hospitals are doing so many TransMedics? Because financially, it’s not possible to do too many...usually you tend to be believe that centers that use the device a lot – maybe they have some incentive to use it that much...Houston, maybe...Henry Ford, maybe....” — Transplant surgeon and division chief of the liver program at a world-renowned academic center", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:45:55+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5372-7340-8f9a-522bc765e528", "parentComponentId": null }, { "bbox": { "h": 0.03, "w": 0.3, "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:04.001+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "f28023c0-8424-4fc3-905d-7d0fa506fed3", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [ { "matchId": "21d95dc8-4cf5-45fa-a78e-75cab43cdaaa", "evidence": "The slide explicitly discusses allegations of kickbacks and investigative inquiries into financial incentives.", "framework": null, "confidence": 0.9, "extraction": { "at": "2026-05-02 20:12:04.001+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 33, "frameworkName": "fraud-exposure" } ], "arcBeats": [], "loops": [], "locked": true }, { "page": 34, "type": "tension", "title": "The slide uses a 'guilt by association' argument, linking TransMedics to a failed company (Nevro) based on demographic patterns in their user base.", "function": "expose_contradiction", "rawType": "expose_contradiction", "block": null, "metadata": { "slideType": "expose_contradiction", "slideTypeCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-124c-75aa-984a-0a3d0d8fc8df", "version": 1, "description": null }, "function": "expose_contradiction", "functionCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-171f-776f-887c-73edaff4cf9c", "version": 1, "description": null }, "density": "dense", "densityScore": 57, "componentCount": 7, "textChars": 1447, "nDataPoints": 1, "notes": "The slide uses a 'guilt by association' argument, linking TransMedics to a failed company (Nevro) based on demographic patterns in their user base.", "elementsJson": [ "paragraph", "line_chart", "quote_block", "footnote" ], "confidence": 0.95, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:12:07.094+00", "seconds": 10.267, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/34", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-34", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "TransMedics bears a striking similarity with Nevro (NVRO), a device company and Scorpion’s first report – both are fueled by a clique of high-volume users of Middle East background.", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:45:58+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a974-632d31b2d17f", "parentComponentId": null }, { "bbox": { "h": 0.35, "w": 0.42, "x": 0.07, "y": 0.55 }, "kind": "chart", "text": "Nevro stock chart, 2020- present", "attrs": null, "canon": { "kind": { "name": "Chart", "slug": "chart", "status": "active", "canonId": "019de52c-f9a0-76ef-adc6-0b859109d1f8", "version": 1, "description": "Quantitative chart." }, "tool": null, "subkind": { "name": "Line chart", "slug": "line", "status": "active", "canonId": "019de52c-ff62-778f-8f6c-a952ceae8677", "version": 1, "description": null }, "framework": null }, "subkind": "line", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:07.094+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "6f3277b1-cd8a-4882-a600-d20962c83d1d", "parentComponentId": null }, { "bbox": null, "kind": "metric", "text": "market cap: 98%", "attrs": null, "canon": { "kind": { "name": "Metric", "slug": "metric", "status": "active", "canonId": "019de52c-f923-73bf-8081-d0b1a8c5264d", "version": 1, "description": "Big-number or KPI value." }, "tool": { "name": "Quantification", "slug": "quantification", "status": "active", "bestFor": null, "canonId": "019dd9e1-47ab-72ce-a079-aab1f5299e88", "version": 1, "bodyDocId": null, "description": "Translating a claim into numbers, charts, or tables.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": "primary", "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:45:58+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a974-6b086ae8b9fb", "parentComponentId": null }, { "bbox": { "h": 0.45, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "paragraph", "text": "As mentioned, we find that nepotism - of both the family and tribal variety - is an infrequent but reliable indicator of fraud. TransMedics bears a striking similarity with Nevro (NVRO), a device company and Scorpion’s first report...", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:07.094+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "b1b3a39f-a462-4152-bc3d-3baf3f150788", "parentComponentId": null }, { "bbox": { "h": 0.35, "w": 0.41, "x": 0.52, "y": 0.55 }, "kind": "quote", "text": "When Nevro developed their cult, and I don't want to seem...they got a lot of Middle Eastern doctors in there...they got this cult of Middle Easterners, Persians, and Arabs and stuff...", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:07.094+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "56fb9775-4b62-4cb9-a906-ec2c48566999", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "“When Nevro developed their cult, and I don’t want to seem...they got a lot of Middle Eastern doctors in there...they got this cult of Middle Easterners, Persians, and Arabs and stuff. And this is not racist – they’re all good docs. When we had these think tanks with Nevro, I was the only white guy there. I think that added to the cult mentality, like this is our thing, this is our bandwagon. It was weird... if you look at the doctors in the forefront...the white-shoe reputable people....that’s not who they got....they brought in a bunch of guys – I wouldn’t say they were outcasts, but...I am blown away because every doctor I know that does a lot of implant volume doesn’t use Nevro except for a small cult.” — Surgeon and ex-Nevro user", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:45:58+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a974-6412d37b73c8", "parentComponentId": null }, { "bbox": { "h": 0.03, "w": 0.3, "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:07.094+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "41854f61-b1c3-4e16-bcc0-70b49a9db08e", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [ { "matchId": "08ad6e43-e091-4fde-af55-22d74fb0ee08", "evidence": "The slide explicitly links nepotism and ethnic networks to fraud indicators.", "framework": null, "confidence": 0.9, "extraction": { "at": "2026-05-02 20:12:07.094+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 34, "frameworkName": "fraud-exposure" } ], "arcBeats": [], "loops": [], "locked": true }, { "page": 35, "type": "appendix", "title": "The slide uses a narrative approach to cast doubt on the reputation of a prominent surgeon, linking him to high mortality rates and unethical practices.", "function": "other", "rawType": "other", "block": null, "metadata": { "slideType": "other", "slideTypeCanon": { "name": "Other (fallback)", "slug": "other", "status": "active", "canonId": "019de52d-0af5-71ed-83de-d51ae245fc43", "version": 1, "description": null }, "function": "other", "functionCanon": { "name": "Other (fallback)", "slug": "other", "status": "active", "canonId": "019de52d-15e1-75bc-99dc-07732380e2ce", "version": 1, "description": null }, "density": "dense", "densityScore": 68, "componentCount": 8, "textChars": 2210, "nDataPoints": 0, "notes": "The slide uses a narrative approach to cast doubt on the reputation of a prominent surgeon, linking him to high mortality rates and unethical practices.", "elementsJson": [ "paragraph", "callout_box", "photo", "headline_text" ], "confidence": 0.9, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:12:06.317+00", "seconds": 9.312, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/35", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-35", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "Sir Magdi recognises he was the man for a time when clinical governance was less tight and ethical positions still fluid. Would his pioneering be possible today? Definitely not, he says.", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:45:57+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5372-7340-8f9b-58aece212657", "parentComponentId": null }, { "bbox": { "h": 0.25, "w": 0.35, "x": 0.07, "y": 0.65 }, "kind": "image", "text": null, "attrs": null, "canon": { "kind": { "name": "Image", "slug": "image", "status": "active", "canonId": "019de52c-f978-701f-a720-51d029d769e7", "version": 1, "description": "Photo, illustration, screenshot or icon." }, "tool": null, "subkind": { "name": "Photo", "slug": "photo", "status": "active", "canonId": "019de52c-fd37-757f-b4a8-ca26d4888875", "version": 1, "description": null }, "framework": null }, "subkind": "photo", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:06.317+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "2770f2bd-e837-4798-9c3e-7df9cb3b2cac", "parentComponentId": null }, { "bbox": { "h": 0.45, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "paragraph", "text": "Egypt punches above its weight when it comes to organ transplants, and seems to export a large number of surgeons to the US and UK, who in the US seem to be rather heavy TransMedics users. We suspect a surgeon named Sir Magdi Yacoub had a lot to do with it. Now 89, he moved to the UK after medical school in Cairo, becoming the UK’s most famous transplant surgeon. Yacoub is a flamboyant publicity hound, prone to photo ops with Royals and “daring” surgical stunts that earned him international condemnation. Articles state he put a baboon’s heart into a child; did open-heart surgery on a terrorist; and did a heart transplant on a 10-day old infant, sparking global rebuke from surgeons. Predictably, when the press looked into why 29 infants allegedly died at his hospital, they reported that it had the second-worst outcomes in the UK – “the majority of the operations...are believed to have been carried out by the pioneering surgeon Sir Magdi Yacoub.”", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:06.317+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "3522d1f8-42fa-458b-bad7-d74c164b82fd", "parentComponentId": null }, { "bbox": { "h": 0.1, "w": 0.49, "x": 0.44, "y": 0.72 }, "kind": "paragraph", "text": "Nationwide survey finds Sir Magdi Yacoub's hospital scoring better only than the Bristol Royal infirmary in heart operations league", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:06.317+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "f478da7f-eb28-424e-9222-aa3549bed3f7", "parentComponentId": null }, { "bbox": { "h": 0.12, "w": 0.86, "x": 0.07, "y": 0.52 }, "kind": "quote", "text": "“Sir Magdi recognises he was the man for a time when clinical governance was less tight and ethical positions still fluid. Would his pioneering be possible today? Definitely not, he says.” – BMA’s The Doctor", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Pull quote", "slug": "pull-quote", "status": "active", "canonId": "019de52c-fbf9-76fe-97e1-a0b7540445c9", "version": 1, "description": null }, "framework": null }, "subkind": "pull-quote", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:06.317+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "20e52dd4-69b2-42a0-90b3-f00db5d2dfbf", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "“the majority of the operations...are believed to have been carried out by the pioneering surgeon Sir Magdi Yacoub.” — The Guardian (implied context) / “Sir Magdi recognises he was the man for a time when clinical governance was less tight and ethical positions still fluid. Would his pioneering be possible today? Definitely not, he says.” — BMA’s The Doctor", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:45:57+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5372-7340-8f9b-5e371b1bd838", "parentComponentId": null }, { "bbox": { "h": 0.05, "w": 0.8, "x": 0.07, "y": 0.94 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts; https://www.theguardian.com/uk/1999/nov/04/audreygillan; https://thedoctor.bma.org.uk/articles/health-society/never-miss-a-beat/; https://www.thenationalnews.com/mena/egypt/2022/12/11/egyptian-british-surgeon-magdi-yacoub-flies-like-a-butterfly-but-is-still-busy-as-can-be/", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:06.317+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "f691f2ee-d101-42a0-96df-9e2d8af8f3d8", "parentComponentId": null }, { "bbox": { "h": 0.05, "w": 0.49, "x": 0.44, "y": 0.65 }, "kind": "title", "text": "Harefield launches death rates inquiry", "attrs": null, "canon": { "kind": { "name": "Title", "slug": "title", "status": "active", "canonId": "019de52c-f7dd-76d9-b848-b1f12bd85cf4", "version": 1, "description": "Slide title or headline." }, "tool": null, "subkind": { "name": "Headline", "slug": "headline", "status": "active", "canonId": "019de52c-fae1-7463-9a7c-d60668eced0d", "version": 1, "description": null }, "framework": null }, "subkind": "headline", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:06.317+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "3455565b-efb4-4cc6-a164-9aa3d26039dc", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [], "arcBeats": [], "loops": [], "locked": true }, { "page": 36, "type": "tension", "title": "The slide uses visual evidence from a conference to link corporate figures with potential conflicts of interest and allegations of misconduct.", "function": "expose_contradiction", "rawType": "expose_contradiction", "block": null, "metadata": { "slideType": "expose_contradiction", "slideTypeCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-124c-75aa-984a-0a3d0d8fc8df", "version": 1, "description": null }, "function": "expose_contradiction", "functionCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-171f-776f-887c-73edaff4cf9c", "version": 1, "description": null }, "density": "sparse", "densityScore": 19, "componentCount": 4, "textChars": 638, "nDataPoints": 0, "notes": "The slide uses visual evidence from a conference to link corporate figures with potential conflicts of interest and allegations of misconduct.", "elementsJson": [ "paragraph", "screenshot", "headshot", "footnote" ], "confidence": 0.95, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:12:05.049+00", "seconds": 7.963, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/36", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-36", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "Ex-employees told us he is unlicensed to practice medicine in the US, yet seems to do exactly that, along with other dubious conduct alleged by customers, that we’ll get to.", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:45:56+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5372-7340-8f9a-f1620b78d432", "parentComponentId": null }, { "bbox": { "h": 0.38, "w": 0.86, "x": 0.07, "y": 0.54 }, "kind": "image", "text": "Egyptian Liver Transplant Society, Dec 5-7 2024, Cairo", "attrs": null, "canon": { "kind": { "name": "Image", "slug": "image", "status": "active", "canonId": "019de52c-f978-701f-a720-51d029d769e7", "version": 1, "description": "Photo, illustration, screenshot or icon." }, "tool": null, "subkind": { "name": "Infographic", "slug": "infographic", "status": "active", "canonId": "019de52c-fe26-750c-9d7d-9f34e21324e8", "version": 1, "description": null }, "framework": null }, "subkind": "infographic", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:05.049+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "d74f7919-3235-4d30-aca5-89983526f8b1", "parentComponentId": null }, { "bbox": { "h": 0.45, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "paragraph", "text": "TMDX originally filed to go public in 2007. The S-1 listed Magdi Yacoub as a Board member. A few weeks ago in early December 2024, what we believe to the “inner circle” at TransMedics appears to have traveled to Cairo for the Egyptian Liver Transplant Society meeting.", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:05.049+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "34e8764c-e926-4302-ad91-c39b3d1fd467", "parentComponentId": null }, { "bbox": { "h": 0.03, "w": 0.86, "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: https://www.facebook.com/story.php/?story_fbid=1001352808677100&id=100064071692009&_rdr; https://www.facebook.com/share/p/19fltDtDfA/ ;", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:05.049+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "24378888-e08f-463a-8947-6dd40e14fa18", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [ { "matchId": "07227321-be6d-44a4-8611-cb9635b51b99", "evidence": "The slide explicitly links corporate figures to 'dubious conduct' and 'kickbacks' to expose potential fraud.", "framework": null, "confidence": 0.9, "extraction": { "at": "2026-05-02 20:12:05.049+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 36, "frameworkName": "fraud-exposure" } ], "arcBeats": [], "loops": [], "locked": true }, { "page": 37, "type": "tension", "title": "The slide uses a Q&A format and direct quotes to build a narrative of a toxic, insular culture.", "function": "expose_contradiction", "rawType": "expose_contradiction", "block": null, "metadata": { "slideType": "expose_contradiction", "slideTypeCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-124c-75aa-984a-0a3d0d8fc8df", "version": 1, "description": null }, "function": "expose_contradiction", "functionCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-171f-776f-887c-73edaff4cf9c", "version": 1, "description": null }, "density": "balanced", "densityScore": 46, "componentCount": 5, "textChars": 2079, "nDataPoints": 0, "notes": "The slide uses a Q&A format and direct quotes to build a narrative of a toxic, insular culture.", "elementsJson": [ "paragraph", "quote_block" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:12:05.408+00", "seconds": 8.084, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/37", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-37", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "A number of ex-employees brought the nepotism to our attention.", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:00+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a974-f58525c84528", "parentComponentId": null }, { "bbox": { "h": 0.42, "w": 0.86, "x": 0.07, "y": 0.52 }, "kind": "list", "text": "Toxic culture with a lot of nepotism; Inner circle allegedly make decisions among themselves; Sister running the lung program allegedly has no formal education", "attrs": null, "canon": { "kind": { "name": "List", "slug": "list", "status": "active", "canonId": "019de52c-f94b-779b-a53b-fd4904a5f4d2", "version": 1, "description": "Bullet or numbered list." }, "tool": null, "subkind": { "name": "Bullet list", "slug": "bullet", "status": "active", "canonId": "019de52c-fc98-7169-a083-5cab805076ca", "version": 1, "description": null }, "framework": null }, "subkind": "bullet", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:05.408+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "02473c8a-a127-4788-af63-8b8910b12382", "parentComponentId": null }, { "bbox": { "h": 0.45, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "paragraph", "text": "A number of ex-employees brought the nepotism to our attention. Unusually, we were able to locate zero information on the CEO’s sister’s educational background or professional qualifications to run their liver product. We located a paper published by Ain Shams university in Egypt that appears to list her as a co-author. Employee color below: “just the toxic culture, this weird secrecy...there’s a lot of nepotism...zero experience...there is some substance about favoring a particular culture over another...even down to some of their drivers...it always seems to be Middle Eastern”; “his sister, heads of other divisions, and then technical officer were Egyptian...some others by marriage...they may have some other relatives...they make decisions among themselves and we didn’t know what’s going on”; “whenever someone’s sister is running the lung program...it was just like Larry, Mo, and Curly running things back there....”", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:05.408+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "b4050420-ebaf-442a-a771-7549df93baba", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "It’s just the toxic culture, this weird secrecy. Waleed’s sister is the product director for the lung division. What Amira says goes as far as lung cases go. The product director for liver - I want to say that his son is also in the company somewhere. Ahmed is his first name. — Former employee; The CEO, his sister, heads of other divisions, and then the technical officer were Egyptian. Some others by marriage; they may have some other relatives. They make decisions among themselves and we didn’t know what’s going on. — Former senior employee; Whenever someone’s sister is running the lung program - things like that. They just built out without knowing what they were doing. And if my team calls their 1-800 number, it was just like Larry, Mo, and Curly running things back there, trying to get a case done. — Transplant surgeon at a high-volume CA academic center", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:00+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a974-fb5537c9e542", "parentComponentId": null }, { "bbox": { "h": 0.03, "w": 0.3, "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:05.408+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "e9d7e780-7e4c-4a01-a5eb-e2b4b4798f98", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [], "arcBeats": [], "loops": [], "locked": true }, { "page": 38, "type": "tension", "title": "This is a short-seller research note attempting to cast doubt on management integrity via association.", "function": "expose_contradiction", "rawType": "expose_contradiction", "block": null, "metadata": { "slideType": "expose_contradiction", "slideTypeCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-124c-75aa-984a-0a3d0d8fc8df", "version": 1, "description": null }, "function": "expose_contradiction", "functionCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-171f-776f-887c-73edaff4cf9c", "version": 1, "description": null }, "density": "balanced", "densityScore": 39, "componentCount": 6, "textChars": 1116, "nDataPoints": 0, "notes": "This is a short-seller research note attempting to cast doubt on management integrity via association.", "elementsJson": [ "paragraph", "headline_text", "footnote" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:12:05.207+00", "seconds": 7.466, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/38", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-38", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "TMDX’s entire “inner circle” appears to have done all of part of their medical training at these two schools: the CEO, the Chief Commercial Officer; the head of its liver program and “Medical Director” who oversees its surgeons; and others.", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:45:56+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5372-7340-8f9a-d99ca925b760", "parentComponentId": null }, { "bbox": { "h": 0.25, "w": 0.5, "x": 0.07, "y": 0.58 }, "kind": "list", "text": "Egyptian court sentences 41 organ traffickers to up to 15 years in prison\nEgypt struggles to stem organ trafficking\nOrgan trafficking in Egypt: 'They locked me in and took my kidney'\nEgypt’s organ traffickers: 'I woke up screaming'", "attrs": null, "canon": { "kind": { "name": "List", "slug": "list", "status": "active", "canonId": "019de52c-f94b-779b-a53b-fd4904a5f4d2", "version": 1, "description": "Bullet or numbered list." }, "tool": null, "subkind": { "name": "Bullet list", "slug": "bullet", "status": "active", "canonId": "019de52c-fc98-7169-a083-5cab805076ca", "version": 1, "description": null }, "framework": null }, "subkind": "bullet", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:05.207+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "1c3eb0ca-0ca7-4012-aefd-39c27b1ed2c9", "parentComponentId": null }, { "bbox": { "h": 0.35, "w": 0.88, "x": 0.07, "y": 0.07 }, "kind": "paragraph", "text": "The three global hotspots for organ trafficking are China, India, and Egypt... TMDX’s entire “inner circle” appears to have done all of part of their medical training at these two schools.", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:05.207+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "ba603e4c-929a-47df-855d-3eb71af6f6ea", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "“They locked me in and took my kidney” — Organ trafficking in Egypt headline. “I woke up screaming” — Egypt's organ traffickers headline.", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:45:56+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5372-7340-8f9a-deb7da37c8b5", "parentComponentId": null }, { "bbox": { "h": 0.05, "w": 0.7, "x": 0.07, "y": 0.91 }, "kind": "source-note", "text": "Source: https://www.universityworldnews.com/post.php?story=20161215114217476; https://www.bbc.com/news/av/world-middle-east-54150076; https://www.theguardian.com/global-development/2019/feb/09/trafficking-people-smugglers-organs-egypt-mediterranean-refugees-migrants", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:05.207+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "a000734b-ea93-4c8f-a236-60acdf40632c", "parentComponentId": null }, { "bbox": { "h": 0.08, "w": 0.6, "x": 0.07, "y": 0.48 }, "kind": "title", "text": "Medical professors in alleged organ trafficking racket", "attrs": null, "canon": { "kind": { "name": "Title", "slug": "title", "status": "active", "canonId": "019de52c-f7dd-76d9-b848-b1f12bd85cf4", "version": 1, "description": "Slide title or headline." }, "tool": null, "subkind": { "name": "Headline", "slug": "headline", "status": "active", "canonId": "019de52c-fae1-7463-9a7c-d60668eced0d", "version": 1, "description": null }, "framework": null }, "subkind": "headline", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:05.207+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "93a5995a-69fa-4f1d-aea6-592c0cf75c7f", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [ { "matchId": "22aeb66f-3e0f-43f4-835b-1c319ba471f8", "evidence": "The slide uses guilt-by-association to undermine the credibility of the company's leadership team.", "framework": null, "confidence": 0.9, "extraction": { "at": "2026-05-02 20:12:05.207+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 38, "frameworkName": "expose_contradiction" } ], "arcBeats": [], "loops": [], "locked": true }, { "page": 39, "type": "tension", "title": "The slide uses visual evidence (event flyer and WhatsApp screenshots) to link a surgeon, a broker, and the company's leadership.", "function": "expose_contradiction", "rawType": "expose_contradiction", "block": null, "metadata": { "slideType": "expose_contradiction", "slideTypeCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-124c-75aa-984a-0a3d0d8fc8df", "version": 1, "description": null }, "function": "expose_contradiction", "functionCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-171f-776f-887c-73edaff4cf9c", "version": 1, "description": null }, "density": "sparse", "densityScore": 22, "componentCount": 5, "textChars": 610, "nDataPoints": 0, "notes": "The slide uses visual evidence (event flyer and WhatsApp screenshots) to link a surgeon, a broker, and the company's leadership.", "elementsJson": [ "paragraph", "screenshot", "footnote" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:12:05.644+00", "seconds": 7.901, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/39", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-39", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "We traded WhatsApp messages and spoke with the middleman, who offered right away to facilitate a dual liver and kidney transplant, and asked us to send the patient immediately to India.", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:45:56+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5372-7340-8f9a-c2297391769a", "parentComponentId": null }, { "bbox": { "h": 0.45, "w": 0.44, "x": 0.07, "y": 0.47 }, "kind": "image", "text": "Event flyer showing panel participants", "attrs": null, "canon": { "kind": { "name": "Image", "slug": "image", "status": "active", "canonId": "019de52c-f978-701f-a720-51d029d769e7", "version": 1, "description": "Photo, illustration, screenshot or icon." }, "tool": null, "subkind": { "name": "Screenshot", "slug": "screenshot", "status": "active", "canonId": "019de52c-fd87-7509-8391-3d79fb339379", "version": 1, "description": null }, "framework": null }, "subkind": "screenshot", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:05.644+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "5e8136b1-4039-40be-9e06-1699d8490f84", "parentComponentId": null }, { "bbox": { "h": 0.45, "w": 0.41, "x": 0.52, "y": 0.47 }, "kind": "image", "text": "Instagram profile and WhatsApp chat logs", "attrs": null, "canon": { "kind": { "name": "Image", "slug": "image", "status": "active", "canonId": "019de52c-f978-701f-a720-51d029d769e7", "version": 1, "description": "Photo, illustration, screenshot or icon." }, "tool": null, "subkind": { "name": "Screenshot", "slug": "screenshot", "status": "active", "canonId": "019de52c-fd87-7509-8391-3d79fb339379", "version": 1, "description": null }, "framework": null }, "subkind": "screenshot", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:05.644+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "ce25b71e-cd57-49bb-b2a0-17a0bee7d9f0", "parentComponentId": null }, { "bbox": { "h": 0.35, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "paragraph", "text": "Given the high-risk nature of the field, we took note that CEO Waleed Hassanein, “super-user” Mark Ghobrial at Houston Methodist, and ex-Board member Magdi Yacoub were on a panel with Dr. Arvinder Soin...", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:05.644+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "d791d806-8c7d-4dfb-acbe-8382764a29f5", "parentComponentId": null }, { "bbox": { "h": 0.03, "w": 0.86, "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: https://www.facebook.com/story.php/?story_fbid=1001352808677100&id=100064071692009&_rdr; https://www.facebook.com/share/p/19FltDtDfA/ ;", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:05.644+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "74b3849d-de94-4fcc-9ecc-be84c9030093", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [], "arcBeats": [], "loops": [], "locked": true }, { "page": 40, "type": "tension", "title": "The slide uses a Q&A transcript format to highlight potential regulatory and ethical misconduct.", "function": "expose_contradiction", "rawType": "expose_contradiction", "block": null, "metadata": { "slideType": "expose_contradiction", "slideTypeCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-124c-75aa-984a-0a3d0d8fc8df", "version": 1, "description": null }, "function": "expose_contradiction", "functionCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-171f-776f-887c-73edaff4cf9c", "version": 1, "description": null }, "density": "dense", "densityScore": 63, "componentCount": 7, "textChars": 2975, "nDataPoints": 0, "notes": "The slide uses a Q&A transcript format to highlight potential regulatory and ethical misconduct.", "elementsJson": [ "paragraph", "quote_block", "footnote" ], "confidence": 0.95, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:12:04.077+00", "seconds": 6.189, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/40", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-40", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "A former employee in a regulatory role alleged a number of troubling interactions with the CEO, such as allegedly being pressured to doctor adverse event reports to downplay any link to TransMedics device.", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:45:57+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5372-7340-8f9b-8fde70b95a24", "parentComponentId": null }, { "bbox": { "h": 0.03, "w": 0.86, "x": 0.07, "y": 0.38 }, "kind": "list", "text": "Employees allegedly asked to find ways to sell the device “countries without approval”", "attrs": null, "canon": { "kind": { "name": "List", "slug": "list", "status": "active", "canonId": "019de52c-f94b-779b-a53b-fd4904a5f4d2", "version": 1, "description": "Bullet or numbered list." }, "tool": null, "subkind": { "name": "Bullet list", "slug": "bullet", "status": "active", "canonId": "019de52c-fc98-7169-a083-5cab805076ca", "version": 1, "description": null }, "framework": null }, "subkind": "bullet", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:04.077+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "e13ec7b6-2791-42ff-b328-127e9400f309", "parentComponentId": null }, { "bbox": { "h": 0.15, "w": 0.86, "x": 0.07, "y": 0.22 }, "kind": "paragraph", "text": "The ex-employee further alleged being pushed to find ways to sell the device in countries where it is not approved; and shared grave concerns about a team of “six or seven” transplant physicians who allegedly visited from China to train on the device.", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:04.077+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "22d7e50c-a153-42d4-947f-08efaff50b53", "parentComponentId": null }, { "bbox": { "h": 0.48, "w": 0.86, "x": 0.07, "y": 0.42 }, "kind": "paragraph", "text": "Q: “Were you ever asked to do anything from a regulatory standpoint that you thought was in a gray area or improper?”\nA: “They tried to sell products to countries without approval - how we can do it?”\nQ: “They asked you to look into how you could do that?”\nA: [Laughs] That’s funny, isn’t it? I was asked what are the kinds of ways they can sell without approval. We got some Chinese doctors who came over for training, and [redacted] was involved with that.”\nQ: “Who asked you to look at countries you could sell to without approval? Waleed?”\nA: “Yeah, from the top...Chinese doctors came and went through the training. This group of Chinese doctors, I think, it was six or seven people who came, and the leader was a German doctor. He was not able to continue medical practice in Germany and then went to China and where was working for several years. He was saying he was trying to be a pioneer of transplants at this Chinese hospital.”\nQ: “This German doctor, he was not allowed to practice in Germany? It’s kind of weird that he went to China.”\nA: “We didn’t know but that was our suspicion - that was the suspicion among those who attended the Chinese training session.”\nQ: “You guys were worried that this guy was not allowed to practice in Germany?”\nA: “Right, right. I mean, the way he spoke...he said that he was helping them to establish a transplant center in the southern area of China somewhere between Wuhan and Beijing...when the Chinese doctors disappeared, we felt kind of easy because we don’t want to do anything illegal...exporting to any country illegally could shut down the business.” - Former employee in a regulatory affairs role", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:04.077+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "db19cda5-47e4-4f40-a6ff-0cd1b6ac3419", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "the leader was a German doctor...he was not able to continue medical practice in Germany and then went to China...he was saying he was trying to be a pioneer of transplants at this Chinese hospital....I mean, the way he spoke...somewhere between Wuhan and Beijing...when the Chinese doctors disappeared, we felt kind of easy because we didn't want to do anything illegal...exporting to any country illegally could shut down the business. — Former employee in a regulatory affairs role", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:45:57+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5372-7340-8f9b-9199cc937f8c", "parentComponentId": null }, { "bbox": { "h": 0.02, "w": 0.25, "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:04.077+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "a346baa5-f145-4c1b-afe5-51c354f539a8", "parentComponentId": null }, { "bbox": { "h": 0.15, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "title", "text": "A former employee in a regulatory role alleged a number of troubling interactions with the CEO, such as allegedly being pressured to doctor adverse event reports to downplay any link to TransMedics device, as we cover in the last chapter.", "attrs": null, "canon": { "kind": { "name": "Title", "slug": "title", "status": "active", "canonId": "019de52c-f7dd-76d9-b848-b1f12bd85cf4", "version": 1, "description": "Slide title or headline." }, "tool": null, "subkind": { "name": "Headline", "slug": "headline", "status": "active", "canonId": "019de52c-fae1-7463-9a7c-d60668eced0d", "version": 1, "description": null }, "framework": null }, "subkind": "headline", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:04.077+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "d4d7e6c8-b9b3-4d72-85cd-e75028bc03ea", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [], "arcBeats": [], "loops": [], "locked": true }, { "page": 41, "type": "setup", "function": "transition", "rawType": "section_divider", "block": null, "metadata": { "slideType": "section_divider", "slideTypeCanon": { "name": "Section divider", "slug": "section_divider", "status": "active", "canonId": "019de52d-066a-7402-9554-6ae504999041", "version": 1, "description": null }, "function": "transition", "functionCanon": { "name": "Transition", "slug": "transition", "status": "active", "canonId": "019de52d-1365-7149-92aa-66df859e75fd", "version": 1, "description": null }, "density": "sparse", "densityScore": 8, "componentCount": 2, "textChars": 340, "nDataPoints": 0, "notes": null, "elementsJson": [ "headline_text" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:12:03.03+00", "seconds": 4.408, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/41", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-41", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "Part 1. TransMedics National OCS Program (NOP): an unsustainable, anti-competitive scheme based on what we believe to be coercive tying, price extortion, and retaliation.", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:45:56+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5372-7340-8f9b-4e5e22e88eb2", "parentComponentId": null }, { "bbox": { "h": 0.153, "w": 0.854, "x": 0.073, "y": 0.069 }, "kind": "title", "text": "Part 1. TransMedics National OCS Program (NOP): an unsustainable, anti-competitive scheme based on what we believe to be coercive tying, price extortion, and retaliation.", "attrs": null, "canon": { "kind": { "name": "Title", "slug": "title", "status": "active", "canonId": "019de52c-f7dd-76d9-b848-b1f12bd85cf4", "version": 1, "description": "Slide title or headline." }, "tool": null, "subkind": { "name": "Headline", "slug": "headline", "status": "active", "canonId": "019de52c-fae1-7463-9a7c-d60668eced0d", "version": 1, "description": null }, "framework": null }, "subkind": "headline", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:03.03+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "8c0ea273-6c4c-4ef5-8ab8-d0b6e3f3ea1b", "parentComponentId": null } ], "metrics": [], "tools": [ { "tool": { "name": "Thesis archetype", "slug": "thesis-archetype", "status": "active", "bestFor": null, "canonId": "019dd9e1-4b0b-7428-9b26-f171d1e753fb", "version": 1, "bodyDocId": null, "description": "A canonical investment / activist thesis shape (breakup, fraud, governance).", "familyLabel": null, "categoryName": null, "categorySlug": null }, "agent": null, "layer": "slide", "agents": null, "matchId": "3afaf9e7-ca18-478b-ac44-f28104b2bee5", "evidence": "Part 1. TransMedics National OCS Program (NOP): an unsustainable, anti-competitive scheme based on what we believe to be coercive tying, price extortion, and retaliation.", "pageRefs": null, "priority": null, "whenToUse": null, "confidence": 0.7, "extraction": { "at": "2026-07-16 23:10:27.495235+00", "model": "or:meta-llama/llama-4-scout", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 41, "whyItWorks": null, "antipattern": null, "cardinality": "optional", "narrativePurpose": null } ], "frameworks": [], "arcBeats": [], "loops": [], "locked": true }, { "page": 42, "type": "tension", "title": "The slide uses a news headline and a snippet of an official letter to frame a corporate controversy.", "function": "expose_contradiction", "rawType": "expose_contradiction", "block": null, "metadata": { "slideType": "expose_contradiction", "slideTypeCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-124c-75aa-984a-0a3d0d8fc8df", "version": 1, "description": null }, "function": "expose_contradiction", "functionCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-171f-776f-887c-73edaff4cf9c", "version": 1, "description": null }, "density": "balanced", "densityScore": 32, "componentCount": 5, "textChars": 840, "nDataPoints": 2, "notes": "The slide uses a news headline and a snippet of an official letter to frame a corporate controversy.", "elementsJson": [ "paragraph", "screenshot", "photo" ], "confidence": 0.95, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:12:02.404+00", "seconds": 3.266, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/42", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-42", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "Congressman Paul Gosar wrote CEO Waleed Hassanein a detailed letter alleging “anti-competitive business practices deployed by TransMedics” tantamount to its medical devices “being held hostage.”", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:45:59+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a974-aa32090e9e7f", "parentComponentId": null }, { "bbox": { "h": 0.45, "w": 0.86, "x": 0.07, "y": 0.37 }, "kind": "image", "text": "Headline and letter snippet", "attrs": null, "canon": { "kind": { "name": "Image", "slug": "image", "status": "active", "canonId": "019de52c-f978-701f-a720-51d029d769e7", "version": 1, "description": "Photo, illustration, screenshot or icon." }, "tool": null, "subkind": { "name": "Screenshot", "slug": "screenshot", "status": "active", "canonId": "019de52c-fd87-7509-8391-3d79fb339379", "version": 1, "description": null }, "framework": null }, "subkind": "screenshot", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:02.404+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "09a6f0cd-396a-4021-b892-3bce0a353c83", "parentComponentId": null }, { "bbox": { "h": 0.18, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "paragraph", "text": "On Feb 21, 2024, Congressman Paul Gosar wrote CEO Waleed Hassanein a detailed letter alleging “anti-competitive business practices deployed by TransMedics” tantamount to its medical devices “being held hostage.” The letter was obtained and published by a news site. The stock fell ~20% from $89 to $72 in days, hovering near the lows for several weeks before spiking again.", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:02.404+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "25092c82-3d9b-4613-a7fb-3799cc477129", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "EXCLUSIVE: Rep. Gosar Accuses TransMedics Of Holding Lifesaving Medical Devices ‘Hostage’ — Vows Oversight — Daily Caller", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:45:59+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a974-ac62b50cc36f", "parentComponentId": null }, { "bbox": { "h": 0.03, "w": 0.45, "x": 0.07, "y": 0.92 }, "kind": "source-note", "text": "Source: https://dailycaller.com/2024/02/22/exclusive-paul-gosar-transmedics-lifesaving-medical-devices-hostage-oversight-ocs/", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:02.404+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "9c31f765-66c3-45eb-8606-185597c790fe", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [ { "matchId": "d0204860-09d6-4c9a-bd2b-cfd865698d04", "evidence": "The slide highlights a specific allegation of anti-competitive behavior and its impact on stock price.", "framework": null, "confidence": 0.8, "extraction": { "at": "2026-05-02 20:12:02.404+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 42, "frameworkName": "fraud-exposure" } ], "arcBeats": [], "loops": [], "locked": true }, { "page": 43, "type": "tension", "title": "The slide presents a narrative of corporate misconduct/extortion based on a letter from a politician.", "function": "expose_contradiction", "rawType": "expose_contradiction", "block": null, "metadata": { "slideType": "expose_contradiction", "slideTypeCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-124c-75aa-984a-0a3d0d8fc8df", "version": 1, "description": null }, "function": "expose_contradiction", "functionCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-171f-776f-887c-73edaff4cf9c", "version": 1, "description": null }, "density": "dense", "densityScore": 58, "componentCount": 6, "textChars": 2479, "nDataPoints": 3, "notes": "The slide presents a narrative of corporate misconduct/extortion based on a letter from a politician.", "elementsJson": [ "paragraph" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:12:07.762+00", "seconds": 4.954, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/43", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-43", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "TransMedics “began to change the entirety of its business model.”", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:01+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a975-1daf6e8ef725", "parentComponentId": null }, { "bbox": { "h": 0.35, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "paragraph", "text": "Gosar accused the CEO of a bait and switch after FDA approval when TransMedics “began to change the entirety of its business model.” He detailed a number of specific practices tantamount to extortion, such as a spike in the cost of disposable cartridges from $7K to $60K. The company also ceased training centers on the device and forced them to pay for a TransMedics technician who would now solely operate the device and “labeled this the National OCS Program, or NOP.” Thus, hospitals could no longer purchase OCS as they had previously done, nor receive training on it. He further stated that centers “were mandated by TransMedics to utilize the OCS no less than three to five times per month” – “if volumes were not maintained, they would not offer more cassettes for purchase.”", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:07.762+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "89750f83-9c5e-4dc3-ac4e-6e535bce2d25", "parentComponentId": null }, { "bbox": { "h": 0.42, "w": 0.86, "x": 0.07, "y": 0.49 }, "kind": "paragraph", "text": "Once FDA approval was achieved, TransMedics began to change the entirety of its business model. Transplant centers that participated in the trial and previously purchased the equipment were then mandated by TransMedics to utilize the OCS no less than three to five times per month, or centers were forced to return the OCS machine without reimbursement of their upfront purchase capital. TransMedics informed these initial centers that if volumes were not maintained, they would not offer more cassettes for purchase. Almost immediately, the cost of the one-time, disposable cassette utilized to encompass the organ during transportation and perfusion increased from the initial $7,000 to greater than $60,000 per disposable cassette. Additionally, transplant centers would no longer receive training for their medical teams to utilize the device at their discretion. Instead, TransMedics created its own team of individuals as the sole source for any initiation of the OCS device and labeled this the National OCS Program, or NOP. Transplant centers could no longer purchase the medical device, rather lease the device and request the necessary TransMedics personnel for any OCS heart, liver, or lung organ recovery. Costs for TransMedics surgical recovery are approximately $20,000 per request.", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:07.762+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "e180465b-de21-4f8e-8c09-b4ea5b200d17", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "“if volumes were not maintained, they would not offer more cassettes for purchase.” — Congressman Paul Gosar letter to TransMedics CEO, Feb 21, 2024", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:01+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a975-210974201601", "parentComponentId": null }, { "bbox": { "h": 0.03, "w": 0.4, "x": 0.07, "y": 0.45 }, "kind": "source-note", "text": "Congressman Paul Gosar letter to TransMedics CEO, Feb 21, 2024", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:07.762+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "843928ef-fd95-469a-93af-07418d7957b2", "parentComponentId": null }, { "bbox": { "h": 0.03, "w": 0.6, "x": 0.07, "y": 0.94 }, "kind": "source-note", "text": "Source: https://dailycaller.com/2024/02/22/exclusive-paul-gosar-transmedics-lifesaving-medical-devices-hostage-oversight-ocs/", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:07.762+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "d8188310-087b-4152-869f-0860e486fce6", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [], "arcBeats": [], "loops": [], "locked": true }, { "page": 44, "type": "tension", "title": "The slide contains two paragraphs of text that are largely redundant, summarizing the same allegation. The source is a Daily Caller article referencing a letter", "function": "expose_contradiction", "rawType": "expose_contradiction", "block": null, "metadata": { "slideType": "expose_contradiction", "slideTypeCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-124c-75aa-984a-0a3d0d8fc8df", "version": 1, "description": null }, "function": "expose_contradiction", "functionCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-171f-776f-887c-73edaff4cf9c", "version": 1, "description": null }, "density": "dense", "densityScore": 53, "componentCount": 6, "textChars": 2476, "nDataPoints": 0, "notes": "The slide contains two paragraphs of text that are largely redundant, summarizing the same allegation. The source is a Daily Caller article referencing a letter from Feb 21, 2024.", "elementsJson": [ "paragraph", "quote_block", "footnote" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:12:10.489+00", "seconds": 7.378, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/44", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-44", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "TransMedics is pressuring hospitals to utilize their more expensive aircraft, not only for transportation of organs, but also for the convenient movement of their staff and equipment.", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:45:57+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5372-7340-8f9b-ba762e46edba", "parentComponentId": null }, { "bbox": { "h": 0.35, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "paragraph", "text": "A key allegation stated that TransMedics coerces hospitals to use its recently-acquired expensive aircraft as part of its new NOP “full service” business model: “in addition to the significantly increased costs borne by transplant centers to utilize the device itself, TransMedics is pressuring hospitals to use their more expensive aircraft, not only for transportation of organs, but also for the convenient of their staff and equipment.” Gosar indicated that “transplant centers have long relied on private air transportation” using inexpensive “no-frills older-model aircraft based near their hospital” to “keep transportation costs low.” However, TransMedics made “significant investments in new model aircraft similar to the types utilized by luxury air charter companies such as Netjets.”", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:10.489+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "580f191a-ac29-4837-831a-e5235f8f5f2c", "parentComponentId": null }, { "bbox": { "h": 0.35, "w": 0.86, "x": 0.07, "y": 0.49 }, "kind": "paragraph", "text": "Given the very short time a human organ can remain viable in transport, transplant centers have long relied on private air transportation to ensure that organs make it to their recipients in time. Historically, transplant centers have sourced their own air transport, typically utilizing well-maintained, but \"no-frills,\" older model aircraft based near their hospital. This enabled hospitals to minimize aircraft repositioning and keep transportation costs low. Recently, TransMedics has made significant investments in new model aircraft similar to the types utilized by luxury air charter companies, such as NetJets. In addition to the significantly increased costs borne by transplant centers to utilize the device itself, TransMedics is pressuring hospitals to utilize their more expensive aircraft, not only for transportation of organs, but also for the convenient movement of their staff and equipment. In some cases, TransMedics has been reported to hold its", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:10.489+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "65c8a3a3-53c9-4626-a599-565ec85c12b4", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "“in addition to the significantly increased costs borne by transplant centers to utilize the device itself, TransMedics is pressuring hospitals to use their more expensive aircraft, not only for transportation of organs, but also for the convenient of their staff and equipment.” — Congressman Paul Gosar letter to TransMedics CEO, Feb 21, 2024", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:45:57+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5372-7340-8f9b-beaa9ee805fa", "parentComponentId": null }, { "bbox": { "h": 0.02, "w": 0.6, "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: https://dailycaller.com/2024/02/22/exclusive-paul-gosar-transmedics-lifesaving-medical-devices-hostage-oversight-ocs/", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:10.489+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "25a91645-bc39-4304-87f5-1b9f896b041f", "parentComponentId": null }, { "bbox": { "h": 0.03, "w": 0.45, "x": 0.07, "y": 0.45 }, "kind": "source-note", "text": "Congressman Paul Gosar letter to TransMedics CEO, Feb 21, 2024", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:10.489+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "ac26f79c-1063-4e66-a361-07faa3967e90", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [], "arcBeats": [], "loops": [], "locked": true }, { "page": 45, "type": "tension", "title": "The slide presents a narrative of corporate malfeasance by quoting a letter from a politician and contrasting it with alleged CEO statements.", "function": "expose_contradiction", "rawType": "expose_contradiction", "block": null, "metadata": { "slideType": "expose_contradiction", "slideTypeCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-124c-75aa-984a-0a3d0d8fc8df", "version": 1, "description": null }, "function": "expose_contradiction", "functionCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-171f-776f-887c-73edaff4cf9c", "version": 1, "description": null }, "density": "dense", "densityScore": 51, "componentCount": 6, "textChars": 2141, "nDataPoints": 0, "notes": "The slide presents a narrative of corporate malfeasance by quoting a letter from a politician and contrasting it with alleged CEO statements.", "elementsJson": [ "paragraph", "footnote" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:12:07.684+00", "seconds": 4.51, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/45", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-45", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "TransMedics has been reported to hold its device hostage, withholding access to lifesaving technology unless hospitals agree to utilize TransMedics aviation's costly planes.", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:45:59+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a974-c6c495419479", "parentComponentId": null }, { "bbox": { "h": 0.35, "w": 0.86, "x": 0.07, "y": 0.48 }, "kind": "paragraph", "text": "movement of their staff and equipment. In some cases, TransMedics has been reported to hold its device hostage, withholding access to their lifesaving technology unless hospitals agree to utilize TransMedics aviation's costly planes. Protests related to the significantly increased costs are often met by the same response from TransMedics: “not to worry, the American taxpayer will foot the bill through Medicare.” In fact, on your recent Q3 earnings call, when pressed about the ability of hospitals to absorb the significantly increased costs associated with TransMedics OCS and TransMedics aviation you stated: \"This is a fact of organ transplant, all aviation and logistics costs are fully reimbursed...there is no limit\" (emphasis added).", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:07.684+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "13024afe-ddd1-4d28-8137-226409d6fd72", "parentComponentId": null }, { "bbox": { "h": 0.35, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "paragraph", "text": "Gosar then detailed a startling allegation: “TransMedics has been reported to hold its device hostage, withholding access to lifesaving technology unless hospitals agree to utilize TransMedics aviation’s costly planes” - a “continuous forced bundling of services” with centers “held hostage by public company that has lost its true north.” In response to “protests” by hospitals alarmed at “significantly increased costs” of the NOP service, TransMedics CEO guided them to aggressively exploit a loophole in Medicare reimbursement for organ transplants, which we shall cover in more detail. Gosar cited the CEO’s comments on an earnings call: “not to worry, the American taxpayer will foot the bill through Medicare”; “this is a fact of organ transplant, all aviation and logistics costs are fully reimbursed...there is no limit.”", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:07.684+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "94c0a4cb-3849-496a-bb0f-16852fb1312f", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "\"This is a fact of organ transplant, all aviation and logistics costs are fully reimbursed...there is no limit\" — TransMedics CEO (as cited in Congressman Paul Gosar letter to TransMedics CEO, Feb 21, 2024).", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:45:59+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a974-cbe822b340b4", "parentComponentId": null }, { "bbox": { "h": 0.03, "w": 0.4, "x": 0.07, "y": 0.43 }, "kind": "source-note", "text": "Congressman Paul Gosar letter to TransMedics CEO, Feb 21, 2024", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:07.684+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "22c49434-a167-47fc-941e-516ec3d4fc43", "parentComponentId": null }, { "bbox": { "h": 0.03, "w": 0.6, "x": 0.07, "y": 0.94 }, "kind": "source-note", "text": "Source: https://dailycaller.com/2024/02/22/exclusive-paul-gosar-transmedics-lifesaving-medical-devices-hostage-oversight-ocs/", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:07.684+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "ba83b298-b3ac-430b-9ede-743217f1c9e3", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [ { "matchId": "516d7fde-b93f-4f36-8a1e-0e1e52b9cd3a", "evidence": "The slide explicitly frames corporate actions as 'hostage' taking and 'loophole' exploitation to be exposed.", "framework": null, "confidence": 0.9, "extraction": { "at": "2026-05-02 20:12:07.684+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 45, "frameworkName": "fraud-exposure" } ], "arcBeats": [], "loops": [], "locked": true }, { "page": 46, "type": "tension", "title": "The slide uses direct quotes from a letter to frame potential corporate misconduct.", "function": "expose_contradiction", "rawType": "expose_contradiction", "block": null, "metadata": { "slideType": "expose_contradiction", "slideTypeCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-124c-75aa-984a-0a3d0d8fc8df", "version": 1, "description": null }, "function": "expose_contradiction", "functionCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-171f-776f-887c-73edaff4cf9c", "version": 1, "description": null }, "density": "dense", "densityScore": 50, "componentCount": 6, "textChars": 1868, "nDataPoints": 0, "notes": "The slide uses direct quotes from a letter to frame potential corporate misconduct.", "elementsJson": [ "paragraph", "numbered_list", "footnote" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 21:25:48.294+00", "seconds": 3.774, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/46", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-46", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "Has TransMedics ever denied a transplant center access to your life saving device unless they use TransMedics aircraft and pilots?", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:45:58+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a973-d90a67915694", "parentComponentId": null }, { "bbox": { "h": 0.02, "w": 0.6, "x": 0.07, "y": 0.95 }, "kind": "disclaimer", "text": "Source: https://dailycaller.com/2024/02/22/exclusive-paul-gosar-transmedics-lifesaving-medical-devices-hostage-oversight-ocs/", "attrs": null, "canon": { "kind": { "name": "Disclaimer", "slug": "disclaimer", "status": "active", "canonId": "91173477-d91f-4024-bbaf-d4f93e3f82dc", "version": 1, "description": "Legal/cautionary text that occupies most of the body of its slide." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:25:48.294+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "17c4dcd3-4bad-4e1b-85ea-34ce0f27d74f", "parentComponentId": null }, { "bbox": { "h": 0.45, "w": 0.86, "x": 0.07, "y": 0.33 }, "kind": "list", "text": "1. Although it is well understood that the use of private aircraft is necessary to ensure that human organs reach their recipient in time, my staff has received allegations that TransMedics uses private aircraft for convenient transportation of their staff and equipment, where no such urgency exists. Has TransMedics ever use private aircraft to transport staff and equipment without the purpose of transporting organs?\n\n4. We understand that TransMedics has made significant investments in new model aircraft and has placed pressure on their hospital customers to utilize their aircraft, despite protests from hospitals that TransMedics Aviation carries significantly higher costs than their current providers. Some transplant centers have reported being pressured to use TransMedics' captive aircraft, at nearly double the cost, or risk losing access to TransMedics' life saving device. Has TransMedics ever denied a transplant center access to your life saving devices unless they use TransMedics' aircraft and pilots?", "attrs": null, "canon": { "kind": { "name": "List", "slug": "list", "status": "active", "canonId": "019de52c-f94b-779b-a53b-fd4904a5f4d2", "version": 1, "description": "Bullet or numbered list." }, "tool": null, "subkind": { "name": "Numbered list", "slug": "numbered", "status": "active", "canonId": "019de52c-fcc0-7718-a284-a4250c805df2", "version": 1, "description": null }, "framework": null }, "subkind": "numbered", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:25:48.294+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "0daf8cda-9c8c-4fa7-b4f5-8f368fb8cdf4", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "Has TransMedics ever used private aircraft to transport staff and equipment without the purpose of transporting organs? — Congressman Paul Gosar letter to TransMedics CEO, Feb 21, 2024", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:45:58+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a973-df8f3baf4a13", "parentComponentId": null }, { "bbox": { "h": 0.03, "w": 0.4, "x": 0.07, "y": 0.27 }, "kind": "source-note", "text": "Congressman Paul Gosar letter to TransMedics CEO, Feb 21, 2024", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:25:48.294+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "5b30fb21-989d-4123-9677-84241e86205e", "parentComponentId": null }, { "bbox": { "h": 0.15, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "title", "text": "Gosar’s letter ended with four specific questions for the CEO. In particular, he asked “Has TransMedics ever used private aircraft to transport staff and equipment without the purpose of transporting organs”; and “Has Transmedics ever denied a transplant center access to your life saving device unless they use TransMedics aircraft and pilots?”", "attrs": null, "canon": { "kind": { "name": "Title", "slug": "title", "status": "active", "canonId": "019de52c-f7dd-76d9-b848-b1f12bd85cf4", "version": 1, "description": "Slide title or headline." }, "tool": null, "subkind": { "name": "Headline", "slug": "headline", "status": "active", "canonId": "019de52c-fae1-7463-9a7c-d60668eced0d", "version": 1, "description": null }, "framework": null }, "subkind": "headline", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:25:48.294+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "bbec56f4-3d28-416a-8687-9e7301349b49", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [], "arcBeats": [], "loops": [], "locked": true }, { "page": 47, "type": "tension", "title": "The slide uses a narrative framing to highlight the CEO's aggressive denial of competitor-driven allegations.", "function": "expose_contradiction", "rawType": "ceo_quote", "block": null, "metadata": { "slideType": "ceo_quote", "slideTypeCanon": { "name": "CEO quote", "slug": "ceo_quote", "status": "active", "canonId": "019de52d-09b6-71c8-93a5-f90a9772a8fa", "version": 1, "description": null }, "function": "expose_contradiction", "functionCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-171f-776f-887c-73edaff4cf9c", "version": 1, "description": null }, "density": "dense", "densityScore": 68, "componentCount": 8, "textChars": 2123, "nDataPoints": 0, "notes": "The slide uses a narrative framing to highlight the CEO's aggressive denial of competitor-driven allegations.", "elementsJson": [ "paragraph", "quote_block", "footnote" ], "confidence": 0.95, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:12:07.64+00", "seconds": 3.552, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/47", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-47", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "The CEO’s denial was absolute and unambiguous: \"the allegations of anticompetitive business practices are unfounded...none of these actions are practiced by TransMedics.\"", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:45:58+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a974-21dc13c94d7f", "parentComponentId": null }, { "bbox": { "h": 0.12, "w": 0.85, "x": 0.07, "y": 0.59 }, "kind": "paragraph", "text": "While we appreciate the opportunity to address the issues raised in your letter, we cannot do so without noting that the hostile and accusatory statements in the letter suggest that you reached inaccurate conclusions based on misinformation and false statements from what appears to be a transplant logistics competitor of TransMedics. We are very disappointed", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:07.64+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "373a7d75-14f0-421f-aace-0975ea2f5744", "parentComponentId": null }, { "bbox": { "h": 0.08, "w": 0.85, "x": 0.07, "y": 0.75 }, "kind": "paragraph", "text": "Similarly, the allegations of anticompetitive business practices are unfounded. Anticompetitive conduct, according to the antitrust laws, refers to practices that unfairly impede competition. None of these actions are practiced by TransMedics. We have always", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:07.64+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "380fc514-79bf-48ef-9296-d6d342dd4036", "parentComponentId": null }, { "bbox": { "h": 0.25, "w": 0.9, "x": 0.07, "y": 0.07 }, "kind": "paragraph", "text": "Five days after Gosar’s letter, TransMedics CEO Hassanein foamed at the mouth in a fiery reply blasting the “extremely serious accusations” as “hostile and accusatory”; as “misinformation and false statements from...a competitor”; and as “inaccurate third-hand reports and unidentified allegations” – lest one confuse them for mere second-hand ones. The CEO’s denial was absolute and unambiguous: “the allegations of anticompetitive business practices are unfounded...none of these actions are practiced by TransMedics.”", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:07.64+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "5dd4ab19-1631-400f-89e8-995f0f77ae39", "parentComponentId": null }, { "bbox": { "h": 0.15, "w": 0.85, "x": 0.07, "y": 0.39 }, "kind": "paragraph", "text": "We are writing in response to your letter dated February 21, 2024, related to TransMedics, Inc. Your letter contained extremely serious accusations and we are responding to these accusations with the same level of seriousness and with factual evidence. Respectfully, we are very disappointed that you have been provided with inaccurate information about TransMedics and the transplantation system, which appears to have led to inaccurate conclusions.", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:07.64+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "f55bad42-6ac0-4b42-9349-0cb1df9958e7", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "“Your letter contained extremely serious accusations and we are responding to these accusations with the same level of seriousness and with factual evidence.” — TransMedics CEO Waleed Hassanein", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:45:58+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a974-25a809c84afd", "parentComponentId": null }, { "bbox": { "h": 0.02, "w": 0.45, "x": 0.07, "y": 0.93 }, "kind": "source-note", "text": "Source: https://investors.transmedics.com/static-files/efba44b7-1826-495f-9787-7805424f00f5", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:07.64+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "9bd1e25e-c036-4ce1-91f4-b31fbde2f2ea", "parentComponentId": null }, { "bbox": { "h": 0.03, "w": 0.75, "x": 0.07, "y": 0.34 }, "kind": "title", "text": "TransMedics CEO Waleed Hassanein reply to Congressman Gosar's letter Feb 26, 2024", "attrs": null, "canon": { "kind": { "name": "Title", "slug": "title", "status": "active", "canonId": "019de52c-f7dd-76d9-b848-b1f12bd85cf4", "version": 1, "description": "Slide title or headline." }, "tool": null, "subkind": { "name": "Headline", "slug": "headline", "status": "active", "canonId": "019de52c-fae1-7463-9a7c-d60668eced0d", "version": 1, "description": null }, "framework": null }, "subkind": "headline", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:07.64+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "4031524d-7246-4486-be8d-6f048b0635e4", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [ { "matchId": "592a5cd6-e8c4-416d-b3c8-9e8d0aef552f", "evidence": "The slide contrasts the CEO's aggressive tone with the formal letter content to highlight a defensive stance.", "framework": null, "confidence": 0.8, "extraction": { "at": "2026-05-02 20:12:07.64+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 47, "frameworkName": "ceo-quote-contradiction" } ], "arcBeats": [], "loops": [], "locked": true }, { "page": 48, "type": "setup", "title": "The slide uses direct quotes from a formal letter to refute claims.", "function": "preempt_rebuttal", "rawType": "preempt_rebuttal", "block": null, "metadata": { "slideType": "preempt_rebuttal", "slideTypeCanon": { "name": "Preempt rebuttal", "slug": "preempt_rebuttal", "status": "active", "canonId": "019de52d-1225-7368-af32-6381fddabdb3", "version": 1, "description": null }, "function": "preempt_rebuttal", "functionCanon": { "name": "Preempt rebuttal", "slug": "preempt_rebuttal", "status": "active", "canonId": "019de52d-18ab-7479-9a7e-820a2f03586a", "version": 1, "description": null }, "density": "dense", "densityScore": 64, "componentCount": 7, "textChars": 2262, "nDataPoints": 1, "notes": "The slide uses direct quotes from a formal letter to refute claims.", "elementsJson": [ "paragraph", "bullet_list" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:12:11.65+00", "seconds": 7.378, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/48", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-48", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "Hassanein vehemently denied each specific allegation in turn, thereby underscoring the gravity of the charges Gosar leveled: that he “prohibited transplant centers from training their personnel on the OCS procedure” – “this statement is not correct”; stated that “transplant centers had the option to either use NOP or continue to operate the OCS on their own”; and that “it couldn’t be further from the truth” regarding “pressuring hospitals to utilize our more expensive logistics.”", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:45:58+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a974-0825279430c7", "parentComponentId": null }, { "bbox": { "h": 0.155, "w": 0.854, "x": 0.073, "y": 0.633 }, "kind": "list", "text": "Your letter accused TransMedics of pressuring hospitals to utilize our more expensive logistics. This couldn’t be further from the truth. TransMedics presents the logistics quotation to transplant centers using our NOP service. The transplant centers then have the final say on whether they want to use our services or not. We are confident,", "attrs": null, "canon": { "kind": { "name": "List", "slug": "list", "status": "active", "canonId": "019de52c-f94b-779b-a53b-fd4904a5f4d2", "version": 1, "description": "Bullet or numbered list." }, "tool": null, "subkind": { "name": "Bullet list", "slug": "bullet", "status": "active", "canonId": "019de52c-fc98-7169-a083-5cab805076ca", "version": 1, "description": null }, "framework": null }, "subkind": "bullet", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:11.65+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "3cf33f28-f398-404f-9487-ce49a4060557", "parentComponentId": null }, { "bbox": { "h": 0.185, "w": 0.854, "x": 0.073, "y": 0.402 }, "kind": "list", "text": "Your letter asserted that TransMedics prohibited transplant centers from training their personnel on the OCS procedure. This statement is not correct. To-date, we have trained more than 400 transplant retrieval surgeons for heart, lung, and liver transplants across the U.S. Importantly, given our clinically focused mission, we are offering to train transplant fellows at academic transplant centers by our senior retrieval surgeons on how to perform OCS donor procurement surgery.", "attrs": null, "canon": { "kind": { "name": "List", "slug": "list", "status": "active", "canonId": "019de52c-f94b-779b-a53b-fd4904a5f4d2", "version": 1, "description": "Bullet or numbered list." }, "tool": null, "subkind": { "name": "Bullet list", "slug": "bullet", "status": "active", "canonId": "019de52c-fc98-7169-a083-5cab805076ca", "version": 1, "description": null }, "framework": null }, "subkind": "bullet", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:11.65+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "6fe6f5e3-8979-499d-a5ab-2d2b26a6111e", "parentComponentId": null }, { "bbox": { "h": 0.215, "w": 0.854, "x": 0.073, "y": 0.068 }, "kind": "paragraph", "text": "Hassanein vehemently denied each specific allegation in turn, thereby underscoring the gravity of the charges Gosar leveled: that he “prohibited transplant centers from training their personnel on the OCS procedure” – “this statement is not correct”; stated that “transplant centers had the option to either use NOP or continue to operate the OCS on their own”; and that “it couldn’t be further from the truth” regarding “pressuring hospitals to utilize our more expensive logistics.”", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:11.65+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "c3c28b82-16cd-460b-9094-a37bb5ad718c", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "“prohibited transplant centers from training their personnel on the OCS procedure” — Congressman Gosar; “this statement is not correct” — Waleed Hassanein; “it couldn’t be further from the truth” — Waleed Hassanein; “pressuring hospitals to utilize our more expensive logistics.” — Congressman Gosar", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:45:58+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a974-0dda875f2e4a", "parentComponentId": null }, { "bbox": { "h": 0.025, "w": 0.45, "x": 0.073, "y": 0.347 }, "kind": "source-note", "text": "TransMedics CEO Waleed Hassanein reply to Congressman Gosar’s letter Feb 26, 2024", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:11.65+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "146b83a1-be1c-47ee-8e24-7017abc10f53", "parentComponentId": null }, { "bbox": { "h": 0.02, "w": 0.4, "x": 0.073, "y": 0.928 }, "kind": "source-note", "text": "Source: https://investors.transmedics.com/static-files/efba44b7-1826-495f-9787-7805424f00f5", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:11.65+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "8db8f5e3-f11e-456d-9431-21887fb282af", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [], "arcBeats": [], "loops": [], "locked": true }, { "page": 49, "type": "tension", "title": "Uses direct quotes from an ex-logistics manager to frame the company as a service provider rather than a medical device company.", "function": "expose_contradiction", "rawType": "expose_contradiction", "block": null, "metadata": { "slideType": "expose_contradiction", "slideTypeCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-124c-75aa-984a-0a3d0d8fc8df", "version": 1, "description": null }, "function": "expose_contradiction", "functionCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-171f-776f-887c-73edaff4cf9c", "version": 1, "description": null }, "density": "dense", "densityScore": 57, "componentCount": 6, "textChars": 2389, "nDataPoints": 2, "notes": "Uses direct quotes from an ex-logistics manager to frame the company as a service provider rather than a medical device company.", "elementsJson": [ "paragraph", "quote_block" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:12:11.67+00", "seconds": 7.122, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/49", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-49", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": { "h": 0.22, "w": 0.86, "x": 0.07, "y": 0.53 }, "kind": "callout", "text": "Not really selling devices but \"selling a service\"\n\"Instead of selling devices, we started selling a service, and we established what we call a National OCS Program, NOP, where we are essentially like Amazon for organs. We have 17 hubs around the country where we have our devices; we have our specialists and our surgeons. Then we bought our own planes. We have a fleet of 14 planes; the fleet is growing. This has been built since last year. In August 2023, we didn't have a single plane. It was managed by third-party providers, and now we have brought all that in-house.\" – Ex-logistics employee at Transmedics", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": null, "subkind": { "name": "Primary callout", "slug": "primary", "status": "active", "canonId": "019de52c-fbd1-70eb-a9ce-8997f8674c1d", "version": 1, "description": null }, "framework": null }, "subkind": "primary", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:11.67+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "2010d9c5-06ab-4cce-8080-62ffbb3eb275", "parentComponentId": null }, { "bbox": { "h": 0.15, "w": 0.86, "x": 0.07, "y": 0.76 }, "kind": "callout", "text": "Sudden pivot from refusing to touch logistics to basing the model around moving aircraft and organ transport\n\"We would contract out all of the logistics and hire third parties for the aviation. We would hire third parties for the ground transportation and so on. We wouldn't touch logistics; somebody else would take care of it for us. A decision was made: we need to bring all the logistics in-house.\" – Ex-logistics employee at Transmedics", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": null, "subkind": { "name": "Primary callout", "slug": "primary", "status": "active", "canonId": "019de52c-fbd1-70eb-a9ce-8997f8674c1d", "version": 1, "description": null }, "framework": null }, "subkind": "primary", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:11.67+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "60b8d575-15b2-4f96-ac10-62bc1b2d9d22", "parentComponentId": null }, { "bbox": null, "kind": "callout", "text": "In a revealing moment, he stated TransMedics is not even really a medical device company: “instead of selling devices, we started selling a service.”", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:45:58+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a973-f44f3eec9712", "parentComponentId": null }, { "bbox": { "h": 0.45, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "paragraph", "text": "Our research indicates that not only are the CEO's denials utterly false, but that the conduct detailed in Gosar's letter is far more serious than he is aware. The allegations and key points in the letter were confirmed by numerous former employees, as well as by major transplant centers that we spoke to across 30+ interviews. We start with an ex-logistics manager who played a key role in managing TMDX's flight operations as part of the NOP, which he told us is \"essentially like Amazon for organs.\" He began by saying that \"in August 2023, we didn't have a single plane\" and \"wouldn't touch logistics\" – \"we would contract out\" and \"hire third parties,\" but that it all changed in a key moment when \"a decision was made: we need to bring all the logistics in house.\" In a revealing moment, he stated TransMedics is not even really a medical device company: \"instead of selling devices, we started selling a service.\"", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:11.67+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "a44e133c-118b-44de-bb73-575608856038", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "“Instead of selling devices, we started selling a service, and we established what we call a National OCS Program, NOP, where we are essentially like Amazon for organs.” — Ex-logistics employee at Transmedics", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:45:58+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a973-fb91a54f9f6e", "parentComponentId": null }, { "bbox": { "h": 0.03, "w": 0.3, "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:11.67+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "f0bdbd40-1f65-44a1-ab87-5623b17e5098", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [], "arcBeats": [], "loops": [], "locked": true }, { "page": 50, "type": "tension", "title": "The slide uses a Q&A format to highlight contradictions between company policy and public statements.", "function": "expose_contradiction", "rawType": "expose_contradiction", "block": null, "metadata": { "slideType": "expose_contradiction", "slideTypeCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-124c-75aa-984a-0a3d0d8fc8df", "version": 1, "description": null }, "function": "expose_contradiction", "functionCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-171f-776f-887c-73edaff4cf9c", "version": 1, "description": null }, "density": "overcrowded", "densityScore": 84, "componentCount": 12, "textChars": 2113, "nDataPoints": 0, "notes": "The slide uses a Q&A format to highlight contradictions between company policy and public statements.", "elementsJson": [ "paragraph", "quote_block" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:12:08.134+00", "seconds": 3.534, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/50", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-50", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "Centers are now forced to use the organ procurement service and TMDX aircraft, according to the ex-employee, contradicting the CEO’s denials.", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:45:59+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a974-974ca6434442", "parentComponentId": null }, { "bbox": { "h": 0.03, "w": 0.86, "x": 0.07, "y": 0.48 }, "kind": "list", "text": "US transplant centers must use the NOP service, while customers abroad can still operate the device themselves", "attrs": null, "canon": { "kind": { "name": "List", "slug": "list", "status": "active", "canonId": "019de52c-f94b-779b-a53b-fd4904a5f4d2", "version": 1, "description": "Bullet or numbered list." }, "tool": null, "subkind": { "name": "Bullet list", "slug": "bullet", "status": "active", "canonId": "019de52c-fc98-7169-a083-5cab805076ca", "version": 1, "description": null }, "framework": null }, "subkind": "bullet", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:08.134+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "3020e802-1236-4018-ab6c-5c51a52085b1", "parentComponentId": null }, { "bbox": { "h": 0.03, "w": 0.86, "x": 0.07, "y": 0.8 }, "kind": "list", "text": "Centers were no longer allowed to operate devices that they already had on the shelf", "attrs": null, "canon": { "kind": { "name": "List", "slug": "list", "status": "active", "canonId": "019de52c-f94b-779b-a53b-fd4904a5f4d2", "version": 1, "description": "Bullet or numbered list." }, "tool": null, "subkind": { "name": "Bullet list", "slug": "bullet", "status": "active", "canonId": "019de52c-fc98-7169-a083-5cab805076ca", "version": 1, "description": null }, "framework": null }, "subkind": "bullet", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:08.134+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "45d392da-0e5e-458b-a22e-f03cdc5c0bdb", "parentComponentId": null }, { "bbox": { "h": 0.03, "w": 0.86, "x": 0.07, "y": 0.71 }, "kind": "list", "text": "Hospitals now \"obliged\" to use TransMedics air transport", "attrs": null, "canon": { "kind": { "name": "List", "slug": "list", "status": "active", "canonId": "019de52c-f94b-779b-a53b-fd4904a5f4d2", "version": 1, "description": "Bullet or numbered list." }, "tool": null, "subkind": { "name": "Bullet list", "slug": "bullet", "status": "active", "canonId": "019de52c-fc98-7169-a083-5cab805076ca", "version": 1, "description": null }, "framework": null }, "subkind": "bullet", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:08.134+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "63df28b3-e32f-4bdb-b8d1-f3e5f171c763", "parentComponentId": null }, { "bbox": { "h": 0.15, "w": 0.86, "x": 0.07, "y": 0.19 }, "kind": "paragraph", "text": "He stated they no longer sell the devices in the US, but still do so abroad – a telling admission given the CEO’s claims that TransMedics must operate the device for quality control. Two former staff provided the same color.", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:08.134+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "28944d81-34c9-41de-a9e5-def2d6ffdd53", "parentComponentId": null }, { "bbox": { "h": 0.06, "w": 0.86, "x": 0.07, "y": 0.51 }, "kind": "quote", "text": "They have to use our clinical service... we would like them to use our plane because that's part of our business.", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Pull quote", "slug": "pull-quote", "status": "active", "canonId": "019de52c-fbf9-76fe-97e1-a0b7540445c9", "version": 1, "description": null }, "framework": null }, "subkind": "pull-quote", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:08.134+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "8a7d2d75-5be4-4492-a21d-79d7f0b97286", "parentComponentId": null }, { "bbox": { "h": 0.06, "w": 0.86, "x": 0.07, "y": 0.62 }, "kind": "quote", "text": "We sell devices in other countries... In the U.S., we no longer sell devices because it just doesn't make sense.", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Pull quote", "slug": "pull-quote", "status": "active", "canonId": "019de52c-fbf9-76fe-97e1-a0b7540445c9", "version": 1, "description": null }, "framework": null }, "subkind": "pull-quote", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:08.134+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "9a4039f3-de6a-466e-b4b7-051641bf2e24", "parentComponentId": null }, { "bbox": { "h": 0.08, "w": 0.86, "x": 0.07, "y": 0.84 }, "kind": "quote", "text": "Yes, you do. Centers that had bought OCS systems were not allowed to buy cartridges unless they used the national program... they were told that they were not going to be able to use it any longer.", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Pull quote", "slug": "pull-quote", "status": "active", "canonId": "019de52c-fbf9-76fe-97e1-a0b7540445c9", "version": 1, "description": null }, "framework": null }, "subkind": "pull-quote", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:08.134+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "f9c796f0-eb9a-4eab-b10e-d1cb17db6078", "parentComponentId": null }, { "bbox": { "h": 0.03, "w": 0.86, "x": 0.07, "y": 0.74 }, "kind": "quote", "text": "centers now are obliged to use their transportation service.", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Pull quote", "slug": "pull-quote", "status": "active", "canonId": "019de52c-fbf9-76fe-97e1-a0b7540445c9", "version": 1, "description": null }, "framework": null }, "subkind": "pull-quote", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:08.134+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "fbd24317-ebe4-4bb4-9d5c-9c680aa1d008", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "They have to use our clinical service. It’s our device and our specialist who’s going to operate it...we would like them to use our plane because that’s part of our business. — Ex-logistics employee at Transmedics; We sell devices in other countries because our devices are available in Europe, the Middle East, and Asia. So, we sell devices there and we sell consumables to them. In the U.S., we no longer sell devices because it just doesn’t make sense. — Ex-logistics employee at Transmedics; I’ve been told that the centers now are obliged to use their transportation service. — Transplant procurement surgeon previously working with TransMedics; Yes, you do. Centers that had bought OCS systems were not allowed to buy cartridges unless they used the national program. — Former executive in a key reimbursement role", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:45:59+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a974-9b0a9336f6ca", "parentComponentId": null }, { "bbox": { "h": 0.02, "w": 0.3, "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:08.134+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "94797ac0-f407-49f1-b90a-9b90ccf884e0", "parentComponentId": null }, { "bbox": { "h": 0.12, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "title", "text": "Centers are now forced to use the organ procurement service and TMDX aircraft, according to the ex-employee, contradicting the CEO’s denials", "attrs": null, "canon": { "kind": { "name": "Title", "slug": "title", "status": "active", "canonId": "019de52c-f7dd-76d9-b848-b1f12bd85cf4", "version": 1, "description": "Slide title or headline." }, "tool": null, "subkind": { "name": "Headline", "slug": "headline", "status": "active", "canonId": "019de52c-fae1-7463-9a7c-d60668eced0d", "version": 1, "description": null }, "framework": null }, "subkind": "headline", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:08.134+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "9af86914-7382-4492-8ec3-e56154125387", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [ { "matchId": "6d94febb-3a35-4292-9fbf-e79d2c2c7a64", "evidence": "The slide explicitly contrasts CEO claims with ex-employee testimony.", "framework": null, "confidence": 0.9, "extraction": { "at": "2026-05-02 20:12:08.134+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 50, "frameworkName": "ceo-quote-contradiction" } ], "arcBeats": [], "loops": [], "locked": true }, { "page": 51, "type": "tension", "title": "The slide uses a 'Q&A' format to document expert interviews, highlighting the lack of choice for customers.", "function": "expose_contradiction", "rawType": "expose_contradiction", "block": null, "metadata": { "slideType": "expose_contradiction", "slideTypeCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-124c-75aa-984a-0a3d0d8fc8df", "version": 1, "description": null }, "function": "expose_contradiction", "functionCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-171f-776f-887c-73edaff4cf9c", "version": 1, "description": null }, "density": "overcrowded", "densityScore": 77, "componentCount": 9, "textChars": 1751, "nDataPoints": 2, "notes": "The slide uses a 'Q&A' format to document expert interviews, highlighting the lack of choice for customers.", "elementsJson": [ "paragraph", "quote_block" ], "confidence": 0.95, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:12:08.329+00", "seconds": 3.474, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/51", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-51", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "you don't have access to their pump unless you use their NOP service.", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:45:58+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a974-8275b8cdbd65", "parentComponentId": null }, { "bbox": { "h": 0.02, "w": 0.45, "x": 0.07, "y": 0.48 }, "kind": "list", "text": "High volume user indicated NOP is utilized 100% of the time", "attrs": null, "canon": { "kind": { "name": "List", "slug": "list", "status": "active", "canonId": "019de52c-f94b-779b-a53b-fd4904a5f4d2", "version": 1, "description": "Bullet or numbered list." }, "tool": null, "subkind": { "name": "Bullet list", "slug": "bullet", "status": "active", "canonId": "019de52c-fc98-7169-a083-5cab805076ca", "version": 1, "description": null }, "framework": null }, "subkind": "bullet", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:08.329+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "6203a4ed-3d91-4169-a8db-ded2027f9e5c", "parentComponentId": null }, { "bbox": { "h": 0.02, "w": 0.5, "x": 0.07, "y": 0.68 }, "kind": "list", "text": "Another surgeon indicated no access to the device without using NOP service", "attrs": null, "canon": { "kind": { "name": "List", "slug": "list", "status": "active", "canonId": "019de52c-f94b-779b-a53b-fd4904a5f4d2", "version": 1, "description": "Bullet or numbered list." }, "tool": null, "subkind": { "name": "Bullet list", "slug": "bullet", "status": "active", "canonId": "019de52c-fc98-7169-a083-5cab805076ca", "version": 1, "description": null }, "framework": null }, "subkind": "bullet", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:08.329+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "be42b84c-60d6-499c-bc3b-78dab7f04edc", "parentComponentId": null }, { "bbox": { "h": 0.08, "w": 0.86, "x": 0.07, "y": 0.22 }, "kind": "paragraph", "text": "One of the highest volume users of the device in the US indicated he has no other option, stating that he uses the device 45-50 times a year and that “we use their national NOP program for all of them.”", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:08.329+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "1f212395-2fcf-4ec6-a4f2-5ea0c564556e", "parentComponentId": null }, { "bbox": { "h": 0.1, "w": 0.86, "x": 0.07, "y": 0.3 }, "kind": "paragraph", "text": "Although the answer was self-evident in his 100% percent utilization of the service, for the avoidance of doubt we asked if using the service is a requirement: “to be completely candid, this is a very small world and I don't know of any program that uses them that doesn't use the NOP.”", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:08.329+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "526eba2c-de74-4754-b79a-b67eb5786e41", "parentComponentId": null }, { "bbox": { "h": 0.06, "w": 0.86, "x": 0.07, "y": 0.4 }, "kind": "paragraph", "text": "A second surgeon, based in Utah, and also one of the company’s highest volume users, corroborated that “you don't have access to their pump” unless you use their NOP service.", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:08.329+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "ccdac8f2-a6b7-4424-8095-856787899637", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "“we use their national NOP program for all of them.” — Transplant hepatologist and director of the liver program at a Midwest academic center; one of TransMedics highest volume users. “to be completely candid, this is a very small world and I don't know of any program that uses them that doesn't use the NOP.” — Transplant hepatologist and director of the liver program at a Midwest academic center; one of TransMedics highest volume users. “you don't have access to their pump” — Transplant surgeon and surgical director at a high volume academic center in the western US; also medical director at a major OPO (organ procurement organization); one of TransMedics highest volume users.", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:45:58+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a974-8729a9de6a9e", "parentComponentId": null }, { "bbox": { "h": 0.02, "w": 0.25, "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:08.329+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "5ea5e09c-bcc7-4c58-807a-859826c8192d", "parentComponentId": null }, { "bbox": { "h": 0.15, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "title", "text": "Transplant surgeons at centers across the US corroborated that they are forced to use the TransMedics NOP service in order to access the device.", "attrs": null, "canon": { "kind": { "name": "Title", "slug": "title", "status": "active", "canonId": "019de52c-f7dd-76d9-b848-b1f12bd85cf4", "version": 1, "description": "Slide title or headline." }, "tool": null, "subkind": { "name": "Headline", "slug": "headline", "status": "active", "canonId": "019de52c-fae1-7463-9a7c-d60668eced0d", "version": 1, "description": null }, "framework": null }, "subkind": "headline", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:08.329+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "c4808024-4c9f-4e5e-843e-a8fb0679a668", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [ { "matchId": "a007bc2e-2ef3-44a5-84ac-3c9de9a56cec", "evidence": "Uses expert testimony from surgeons to validate a claim about business practices.", "framework": null, "confidence": 0.9, "extraction": { "at": "2026-05-02 20:12:08.329+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 51, "frameworkName": "authority-citation" } ], "arcBeats": [], "loops": [], "locked": true }, { "page": 52, "type": "tension", "title": "The slide uses Q&A transcripts to highlight forced reliance on third-party technicians and procurement teams, which the experts view as a significant operationa", "function": "expose_contradiction", "rawType": "expose_contradiction", "block": null, "metadata": { "slideType": "expose_contradiction", "slideTypeCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-124c-75aa-984a-0a3d0d8fc8df", "version": 1, "description": null }, "function": "expose_contradiction", "functionCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-171f-776f-887c-73edaff4cf9c", "version": 1, "description": null }, "density": "overcrowded", "densityScore": 78, "componentCount": 11, "textChars": 1608, "nDataPoints": 0, "notes": "The slide uses Q&A transcripts to highlight forced reliance on third-party technicians and procurement teams, which the experts view as a significant operational drawback.", "elementsJson": [ "paragraph", "quote_block" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:12:09.371+00", "seconds": 4.387, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/52", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-52", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "You don't have another option.", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:03+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a976-001919b6bb7f", "parentComponentId": null }, { "bbox": { "h": 0.08, "w": 0.86, "x": 0.07, "y": 0.38 }, "kind": "list", "text": "The cardiologist stated they now rarely use the device since they’re forced to use the NOP: “the other thing that’s really driven use away is they were essentially mandating, requiring you to use their surgeons and their procurement teams for these hearts.”", "attrs": null, "canon": { "kind": { "name": "List", "slug": "list", "status": "active", "canonId": "019de52c-f94b-779b-a53b-fd4904a5f4d2", "version": 1, "description": "Bullet or numbered list." }, "tool": null, "subkind": { "name": "Bullet list", "slug": "bullet", "status": "active", "canonId": "019de52c-fc98-7169-a083-5cab805076ca", "version": 1, "description": null }, "framework": null }, "subkind": "bullet", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:09.371+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "189b66db-603f-47fe-a643-d04b602227a2", "parentComponentId": null }, { "bbox": { "h": 0.08, "w": 0.86, "x": 0.07, "y": 0.3 }, "kind": "list", "text": "The surgeon emphatically agreed with Congressman Gosar's allegations, stating that his letter is “completely honest...it’s a very honest letter” and that “you don’t have another option” besides using TMDX’s technicians and air transport.", "attrs": null, "canon": { "kind": { "name": "List", "slug": "list", "status": "active", "canonId": "019de52c-f94b-779b-a53b-fd4904a5f4d2", "version": 1, "description": "Bullet or numbered list." }, "tool": null, "subkind": { "name": "Bullet list", "slug": "bullet", "status": "active", "canonId": "019de52c-fc98-7169-a083-5cab805076ca", "version": 1, "description": null }, "framework": null }, "subkind": "bullet", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:09.371+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "825309f6-af0b-4ac7-b061-e2e20149deba", "parentComponentId": null }, { "bbox": { "h": 0.15, "w": 0.86, "x": 0.07, "y": 0.71 }, "kind": "paragraph", "text": "A: “The other thing that’s really driven us away is they were essentially mandating, requiring you to use their surgeons and their procurement teams for these hearts... It’s harder to do this when a team that you don’t work with on a regular basis is just sending you cell phone videos of this is what it looks like, etc.”", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:09.371+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "006f8fb7-2421-40ab-8678-1001218c676e", "parentComponentId": null }, { "bbox": { "h": 0.08, "w": 0.86, "x": 0.07, "y": 0.22 }, "kind": "paragraph", "text": "Two physicians - a liver transplant surgeon in a leadership role and a transplant cardiologist – detailed their dubious view of TransMedics and why their usage of the device has fallen off a cliff.", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:09.371+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "5bf83ec6-31f3-48f9-ac44-b58f74e5eed4", "parentComponentId": null }, { "bbox": { "h": 0.02, "w": 0.2, "x": 0.07, "y": 0.68 }, "kind": "paragraph", "text": "“Mandating” usage of NOP", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:09.371+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "83f5f139-693f-498b-b846-ce1a35ac5bc3", "parentComponentId": null }, { "bbox": { "h": 0.02, "w": 0.35, "x": 0.07, "y": 0.47 }, "kind": "paragraph", "text": "No other option but to use the NOP service", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:09.371+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "921f5165-d989-45ee-a47e-6ce6b4bbf8c5", "parentComponentId": null }, { "bbox": { "h": 0.08, "w": 0.86, "x": 0.07, "y": 0.5 }, "kind": "paragraph", "text": "Q: “Do you have to use their perfusionist and transportation?”\nA: “That’s absolutely right, yes. You don’t have another option.”", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:09.371+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "b6109ec9-1359-44f7-8771-d01447aabf6b", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "You cannot do it. They have to do it. That's for sure. That's the reason I'm telling you, I believe that that letter is completely honest. It's a very honest letter. — Transplant surgeon in a leadership role at Vanderbilt", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:03+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a976-04bb871112f9", "parentComponentId": null }, { "bbox": { "h": 0.02, "w": 0.25, "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:09.371+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "2bc6496a-9d6b-42c9-b836-4831f780b786", "parentComponentId": null }, { "bbox": { "h": 0.15, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "title", "text": "Vanderbilt University is one of the world's pre-eminent and highest volume transplant centers.", "attrs": null, "canon": { "kind": { "name": "Title", "slug": "title", "status": "active", "canonId": "019de52c-f7dd-76d9-b848-b1f12bd85cf4", "version": 1, "description": "Slide title or headline." }, "tool": null, "subkind": { "name": "Headline", "slug": "headline", "status": "active", "canonId": "019de52c-fae1-7463-9a7c-d60668eced0d", "version": 1, "description": null }, "framework": null }, "subkind": "headline", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:09.371+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "73b6f30a-833c-4511-9646-38d812b70e7e", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [], "arcBeats": [], "loops": [], "locked": true }, { "page": 53, "type": "tension", "title": "The slide uses a Q&A format to highlight alleged anti-competitive practices and coercive business tactics.", "function": "expose_contradiction", "rawType": "expose_contradiction", "block": null, "metadata": { "slideType": "expose_contradiction", "slideTypeCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-124c-75aa-984a-0a3d0d8fc8df", "version": 1, "description": null }, "function": "expose_contradiction", "functionCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-171f-776f-887c-73edaff4cf9c", "version": 1, "description": null }, "density": "dense", "densityScore": 64, "componentCount": 7, "textChars": 3527, "nDataPoints": 0, "notes": "The slide uses a Q&A format to highlight alleged anti-competitive practices and coercive business tactics.", "elementsJson": [ "paragraph", "quote_block" ], "confidence": 0.95, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:12:11.702+00", "seconds": 6.407, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/53", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-53", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "If I send my own surgeon, it’s going to cost me more money because I have to pay for two transportations...basically, they are forcing you to do it...if I send my own surgeon, it’s going to cost me more money.", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-23 01:18:10+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-70f3-714d-84bf-57f2b50b1172", "parentComponentId": null }, { "bbox": { "h": 0.35, "w": 0.86, "x": 0.07, "y": 0.38 }, "kind": "paragraph", "text": "Q: “When you want to use TransMedics, do you have to use their NOP, their procurement service or can the OPO send their own person?”\nA: “The way that they set it up, it is cheaper for me to ask a TransMedics surgeon to go and recover the liver than sending my own surgeon. If I send my own surgeon, it’s going to cost me more money because I have to pay for two transportations. I have to pay the transportation for my surgeon to go to the hospital, and I also have to pay the transportation of the people from TransMedics that they have to go to the hospital and then they have to come back to my hospital. They created a very, very smart business model.”\nQ: “Did you see that letter that the congressman wrote?\nA: “Oh yeah. I did. Right now, the way that the business model is developed, yes. Basically, they are forcing you to do it. If you don’t do it, I mean, they’re going to tell you, oh no, you can send your own surgeon. Yeah, you can, but it’s more expensive. You don’t want to do that, right? You are trying to reduce costs. If I send my own surgeon, it’s going to cost me more money, so I don’t want to do it. So then, I just let them do it.” - Transplant surgeon in a leadership role at Vanderbilt", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:11.702+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "89df0a70-cb15-4a1e-b2ca-a433e2a968f2", "parentComponentId": null }, { "bbox": { "h": 0.22, "w": 0.86, "x": 0.07, "y": 0.74 }, "kind": "paragraph", "text": "“Mandated” to use the NOP\nQ: “When you want to use TransMedics, do you have to use their NOP, their procurement service or can the OPO send their own person?”\nA: “My understanding is that it’s mandated. The way our surgeons describe it is that it’s mandated, and in the last 7-8 months, for example, whenever we use the OCS system, it’s always been the TransMedics procurement team.”\nQ: “So, they’re forcing you to use it. They won’t let you use it with your own surgeon, your own air transport?”\nA: “Exactly. Everything relating to surgical procurement, use of the OCS device, aviation, etc., they’re trying to put it on their end to the point where I think in one of their recent quarterly reports they talked about how they purchased x number of new airplanes.” - Transplant cardiologist at one of the top centers in the US/world", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:11.702+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "aafb0250-9bc5-4ad7-ab86-166f71474848", "parentComponentId": null }, { "bbox": { "h": 0.25, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "paragraph", "text": "The Vanderbilt transplant cardiologist indicated that “everything related to surgical procurement, use of the OCS device, air transport etc.” was “mandated” and wryly noted the company’s promotion of its brand new jets on quarterly calls. His surgical colleague in the liver program described a key aspect of how the scheme works. If a transplant center refuses to use TransMedics aircraft, they allegedly retaliate by the forcing the center to absorb the cost of two planes – one with the TransMedics device technician, and a second that the center hires for its surgical team: “if I send my own surgeon, it’s going to cost me more money because I have to pay for two transportations…basically, they are forcing you to do it…if I send my own surgeon, it’s going to cost me more money.”", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:11.702+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "be7eafc2-2936-4be1-b000-ef4428ac7fc6", "parentComponentId": null }, { "bbox": { "h": 0.03, "w": 0.86, "x": 0.07, "y": 0.34 }, "kind": "paragraph", "text": "TransMedics forces centers to use the NOP by spiking the cost if they use their own transportation", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:11.702+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "cdad1c9f-e442-4187-988e-0d6ac0411eee", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "“The way that they set it up, it is cheaper for me to ask a TransMedics surgeon to go and recover the liver than sending my own surgeon. I have to pay for two transportations...basically, they are forcing you to do it...if I send my own surgeon, it’s going to cost me more money.” — Transplant surgeon in a leadership role at Vanderbilt", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-23 01:18:10+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-70f3-714d-84bf-5afdd4789d29", "parentComponentId": null }, { "bbox": { "h": 0.02, "w": 0.3, "x": 0.07, "y": 0.96 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:11.702+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "64cd9fc4-a179-4858-be4f-c7053a2a98d3", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [], "arcBeats": [], "loops": [], "locked": true }, { "page": 54, "type": "tension", "title": "The slide uses Q&A transcript excerpts to build a negative narrative about the company's business practices.", "function": "name_villain", "rawType": "villain_critique", "block": null, "metadata": { "slideType": "villain_critique", "slideTypeCanon": { "name": "Villain critique", "slug": "villain_critique", "status": "active", "canonId": "019de52d-10bc-7136-bf20-09de59d17447", "version": 1, "description": null }, "function": "name_villain", "functionCanon": { "name": "Name villain", "slug": "name_villain", "status": "active", "canonId": "019de52d-1746-70d6-bc58-5eeaf5865526", "version": 1, "description": null }, "density": "balanced", "densityScore": 39, "componentCount": 7, "textChars": 734, "nDataPoints": 0, "notes": "The slide uses Q&A transcript excerpts to build a negative narrative about the company's business practices.", "elementsJson": [ "paragraph", "quote_block" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:12:12.005+00", "seconds": 6.519, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/54", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-54", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "a lot of people in different transplant centers are very pissed off with the company...I can tell you, I hate the CEO.", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:00+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a975-08eb64ebda70", "parentComponentId": null }, { "bbox": { "h": 0.45, "w": 0.86, "x": 0.07, "y": 0.47 }, "kind": "list", "text": "Transcript excerpts detailing the bait-and-switch allegations and operational friction.", "attrs": null, "canon": { "kind": { "name": "List", "slug": "list", "status": "active", "canonId": "019de52c-f94b-779b-a53b-fd4904a5f4d2", "version": 1, "description": "Bullet or numbered list." }, "tool": null, "subkind": { "name": "Bullet list", "slug": "bullet", "status": "active", "canonId": "019de52c-fc98-7169-a083-5cab805076ca", "version": 1, "description": null }, "framework": null }, "subkind": "bullet", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:12.005+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "c2c2ab21-ec9a-436b-a2b0-ca1a2b89d209", "parentComponentId": null }, { "bbox": { "h": 0.03, "w": 0.6, "x": 0.07, "y": 0.7 }, "kind": "paragraph", "text": "Vanderbilt slashed usage of the device after being forced to use the NOP services", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:12.005+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "3377f238-c2ce-4bd0-a3f3-246294993de0", "parentComponentId": null }, { "bbox": { "h": 0.03, "w": 0.5, "x": 0.07, "y": 0.44 }, "kind": "paragraph", "text": "Duped trial centers; alienated transplant centers across the country", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:12.005+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "caeeb8ff-4d74-40d3-b0cd-d0ff57f19958", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "“I don't like the Transmedics people that much - I was a [redacted] when they did the initial trial... they completely changed.” — Transplant cardiologist at one of the top centers in the US/world", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:00+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a975-0cb9b9c0889a", "parentComponentId": null }, { "bbox": { "h": 0.03, "w": 0.3, "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:12.005+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "b7729454-af75-4915-be81-35e529b452e9", "parentComponentId": null }, { "bbox": { "h": 0.15, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "title", "text": "The Vanderbilt surgeon stated he played a role in TransMedics’ pivotal PROTECT trial but soured after they did a bait-and-switch", "attrs": null, "canon": { "kind": { "name": "Title", "slug": "title", "status": "active", "canonId": "019de52c-f7dd-76d9-b848-b1f12bd85cf4", "version": 1, "description": "Slide title or headline." }, "tool": null, "subkind": { "name": "Headline", "slug": "headline", "status": "active", "canonId": "019de52c-fae1-7463-9a7c-d60668eced0d", "version": 1, "description": null }, "framework": null }, "subkind": "headline", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:12.005+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "8b4075cf-4aff-40b6-8497-244c5b74c1cd", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [], "arcBeats": [], "loops": [], "locked": true }, { "page": 55, "type": "tension", "title": "The slide uses direct quotes and Q&A transcripts to build a case of corporate coercion.", "function": "expose_contradiction", "rawType": "expose_contradiction", "block": null, "metadata": { "slideType": "expose_contradiction", "slideTypeCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-124c-75aa-984a-0a3d0d8fc8df", "version": 1, "description": null }, "function": "expose_contradiction", "functionCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-171f-776f-887c-73edaff4cf9c", "version": 1, "description": null }, "density": "balanced", "densityScore": 45, "componentCount": 6, "textChars": 1442, "nDataPoints": 0, "notes": "The slide uses direct quotes and Q&A transcripts to build a case of corporate coercion.", "elementsJson": [ "paragraph", "callout_box", "footnote" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:12:08.436+00", "seconds": 2.837, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/55", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-55", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "In sharp contrast to the CEO’s denials, every major transplant center we spoke with described what sounds to us like a racket, where they have no choice but to use TransMedics high-cost jets for air transport.", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:04+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a977-0505ecff8702", "parentComponentId": null }, { "bbox": { "h": 0.45, "w": 0.86, "x": 0.07, "y": 0.41 }, "kind": "list", "text": "UCSF indicated that NOP usage is required... USC tried pushing back but steamrolled into using the NOP service", "attrs": null, "canon": { "kind": { "name": "List", "slug": "list", "status": "active", "canonId": "019de52c-f94b-779b-a53b-fd4904a5f4d2", "version": 1, "description": "Bullet or numbered list." }, "tool": null, "subkind": { "name": "Bullet list", "slug": "bullet", "status": "active", "canonId": "019de52c-fc98-7169-a083-5cab805076ca", "version": 1, "description": null }, "framework": null }, "subkind": "bullet", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:08.436+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "74a340b3-407a-468b-9327-9954e1338362", "parentComponentId": null }, { "bbox": { "h": 0.15, "w": 0.86, "x": 0.07, "y": 0.22 }, "kind": "paragraph", "text": "UCSF stated “I don’t think there’s another option. That’s what you have to do.” USC provided the same color. A transplant surgeon complained that “we’ve pushed back saying we don’t need your surgeon and we don’t need your aviation company” but were bulldozed to the point that “in 2023, almost every liver was through the NOP.” He stated TransMedics recent growth has come from “pushing every liver program not to use their OCS system as an a la carte item but as part of their NOP program.”", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:08.436+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "9207cde2-af50-4644-97c0-37215a0752b3", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "I don’t think there’s another option. That’s what you have to do. — UCSF administrator; They increased their revenue in liver in 2023 by pushing every liver program not to use their OCS system as an a la carte item, but as part of their NOP program. We’ve pushed back saying we don’t need your surgeon and we don’t need your aviation company. — USC transplant surgeon", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:04+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a977-0bd218f689b4", "parentComponentId": null }, { "bbox": { "h": 0.03, "w": 0.3, "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:08.436+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "b52c396f-adca-416d-8cb2-8601354b3905", "parentComponentId": null }, { "bbox": { "h": 0.15, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "title", "text": "In sharp contrast to the CEO's denials, every major transplant center we spoke with described what sounds to us like a racket, where they have no choice but to use TransMedics high-cost jets for air transport.", "attrs": null, "canon": { "kind": { "name": "Title", "slug": "title", "status": "active", "canonId": "019de52c-f7dd-76d9-b848-b1f12bd85cf4", "version": 1, "description": "Slide title or headline." }, "tool": null, "subkind": { "name": "Headline", "slug": "headline", "status": "active", "canonId": "019de52c-fae1-7463-9a7c-d60668eced0d", "version": 1, "description": null }, "framework": null }, "subkind": "headline", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:08.436+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "9ec6920f-205d-486b-916e-8c0b2790133e", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [ { "matchId": "65afdace-1dbd-4e05-a753-706c827a48d9", "evidence": "Contradicting CEO statements with expert testimony to allege coercive business practices.", "framework": null, "confidence": 0.9, "extraction": { "at": "2026-05-02 20:12:08.436+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 55, "frameworkName": "fraud-exposure" } ], "arcBeats": [], "loops": [], "locked": true }, { "page": 56, "type": "tension", "title": "The slide uses a 'he said, she said' structure to highlight a potential fraud or misrepresentation by the CEO.", "function": "expose_contradiction", "rawType": "expose_contradiction", "block": null, "metadata": { "slideType": "expose_contradiction", "slideTypeCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-124c-75aa-984a-0a3d0d8fc8df", "version": 1, "description": null }, "function": "expose_contradiction", "functionCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-171f-776f-887c-73edaff4cf9c", "version": 1, "description": null }, "density": "dense", "densityScore": 58, "componentCount": 7, "textChars": 1843, "nDataPoints": 0, "notes": "The slide uses a 'he said, she said' structure to highlight a potential fraud or misrepresentation by the CEO.", "elementsJson": [ "paragraph", "quote_block" ], "confidence": 0.95, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 21:25:47.602+00", "seconds": 2.872, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/56", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-56", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "The CEO vehemently denied this in his reply to Gosar’s letter, but his statements appear to be false.", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:03+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a976-686d3ab859e8", "parentComponentId": null }, { "bbox": { "h": 0.35, "w": 0.9, "x": 0.05, "y": 0.5 }, "kind": "list", "text": "Expert testimony from top liver transplant surgeons claiming they are no longer allowed to operate the device or receive training, contradicting the CEO's letter.", "attrs": null, "canon": { "kind": { "name": "List", "slug": "list", "status": "active", "canonId": "019de52c-f94b-779b-a53b-fd4904a5f4d2", "version": 1, "description": "Bullet or numbered list." }, "tool": null, "subkind": { "name": "Bullet list", "slug": "bullet", "status": "active", "canonId": "019de52c-fc98-7169-a083-5cab805076ca", "version": 1, "description": null }, "framework": null }, "subkind": "bullet", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:25:47.602+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "fe0cf551-33b3-431f-81b4-4b9bfe2aae11", "parentComponentId": null }, { "bbox": { "h": 0.15, "w": 0.9, "x": 0.05, "y": 0.15 }, "kind": "paragraph", "text": "As part of the aggressive conduct, centers stated that TransMedics no longer allows transplant physicians or technicians to even train on the device, in contrast to its previous practice. The CEO vehemently denied this in his reply to Gosar's letter, but his statements appear to be false.", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:25:47.602+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "1f851d7b-02eb-4d65-8007-63765992e143", "parentComponentId": null }, { "bbox": { "h": 0.1, "w": 0.6, "x": 0.05, "y": 0.35 }, "kind": "quote", "text": "Your letter asserted that TransMedics prohibited transplant centers from training their personnel on the OCS procedure. This statement is not correct.", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Pull quote", "slug": "pull-quote", "status": "active", "canonId": "019de52c-fbf9-76fe-97e1-a0b7540445c9", "version": 1, "description": null }, "framework": null }, "subkind": "pull-quote", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:25:47.602+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "e09ed205-7752-4c77-9f97-10304202c842", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "Your letter asserted that TransMedics prohibited transplant centers from training their personnel on the OCS procedure. This statement is not correct. To-date, we have trained more than 400 transplant retrieval surgeons for heart, lung, and liver transplants across the U.S. — TransMedics CEO Waleed Hassanein. \"Originally, you could do operate the device yourself or use their service. I’ve heard this now, that more recently, they don’t allow you to do it...they won’t train you to do it...it is a little disconcerting. I don’t know why they would do it that way.\" — One of the top liver transplant surgeons in the world. \"Yeah, I think it is gimmicky...I don’t like the way they keep ratcheting down the screws, and as I’ve heard, if they’re not training programs to operate the machine and they’re forcing everybody to use the NOP program, that’s really unethical.\" — One of the top liver transplant surgeons in the world.", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:03+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a976-6c71f9493685", "parentComponentId": null }, { "bbox": { "h": 0.03, "w": 0.7, "x": 0.05, "y": 0.95 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts; https://investors.transmedics.com/static-files/efba44b7-1826-495f-9787-7805424f00f5", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:25:47.602+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "50d31283-22fe-4c95-a9ae-38c74c93809b", "parentComponentId": null }, { "bbox": { "h": 0.1, "w": 0.9, "x": 0.05, "y": 0.05 }, "kind": "title", "text": "TransMedics' Alleged Anti-Competitive Conduct and Contradictory Statements", "attrs": null, "canon": { "kind": { "name": "Title", "slug": "title", "status": "active", "canonId": "019de52c-f7dd-76d9-b848-b1f12bd85cf4", "version": 1, "description": "Slide title or headline." }, "tool": null, "subkind": { "name": "Headline", "slug": "headline", "status": "active", "canonId": "019de52c-fae1-7463-9a7c-d60668eced0d", "version": 1, "description": null }, "framework": null }, "subkind": "headline", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:25:47.602+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "6387cb5a-97c9-4c8a-bc97-2daf07e6d586", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [ { "matchId": "3cb9b7f8-f088-439a-b2fd-5d17717eb785", "evidence": "The slide explicitly contrasts a CEO's official statement with expert testimony to allege a falsehood.", "framework": null, "confidence": 0.9, "extraction": { "at": "2026-05-02 21:25:47.602+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 56, "frameworkName": "fraud-exposure" } ], "arcBeats": [], "loops": [], "locked": true }, { "page": 57, "type": "tension", "title": "The slide uses a 'he-said, she-said' structure to frame the company's NOP service as a potential antitrust issue.", "function": "expose_contradiction", "rawType": "expose_contradiction", "block": null, "metadata": { "slideType": "expose_contradiction", "slideTypeCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-124c-75aa-984a-0a3d0d8fc8df", "version": 1, "description": null }, "function": "expose_contradiction", "functionCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-171f-776f-887c-73edaff4cf9c", "version": 1, "description": null }, "density": "dense", "densityScore": 64, "componentCount": 7, "textChars": 3479, "nDataPoints": 0, "notes": "The slide uses a 'he-said, she-said' structure to frame the company's NOP service as a potential antitrust issue.", "elementsJson": [ "paragraph", "quote_block", "footnote" ], "confidence": 0.95, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:12:10.562+00", "seconds": 4.812, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/57", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-57", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "TransMedics strikes us as textbook case whereby it appears that customers are 1) forced to pay for a NOP service they do not want... and 2) to do so at a higher price than if they purchased each service themselves versus a bundle.", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-23 01:18:10+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-70f3-714d-84bf-68c170393d2e", "parentComponentId": null }, { "bbox": { "h": 0.15, "w": 0.86, "x": 0.07, "y": 0.16 }, "kind": "paragraph", "text": "TransMedics strikes us as textbook case whereby it appears that customers are 1) forced to pay for a NOP service they do not want... and 2) to do so at a higher price than if they purchased each service themselves versus a bundle.", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:10.562+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "24d67538-b523-4bdd-ba30-307d92a05b25", "parentComponentId": null }, { "bbox": { "h": 0.15, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "paragraph", "text": "In the context of anticompetitive behavior as alleged in Congressman Gosar’s letter, extortion occurs when customers are coerced to use a more expensive product/service through the unlawful practice of product bundling.", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:10.562+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "77a229e5-598f-4f81-a390-eb56c2ded018", "parentComponentId": null }, { "bbox": { "h": 0.45, "w": 0.86, "x": 0.07, "y": 0.48 }, "kind": "quote", "text": "Your letter characterized our NOP program as a means to reduce access to the OCS technology and increase prices and profitability. This is not correct. Contrary to the Your letter accused TransMedics of pressuring hospitals to utilize our more expensive logistics. This couldn’t be further from the truth. The transplant centers then have the final say on whether they want to use our services or not. We are confident, given the above efficient way of operating our fleet, and our cost-sharing model with transplant centers that our quotes are lower than competitors who use the outdated brokerage model. Your letter painted an inaccurate picture of the charter flight logistics for organ transplants in the US and accused TransMedics of creating a logistical network with newer aircrafts to unjustly increase cost on our clinical users. Again, this is not correct. Here are the facts. Transplant centers had the option to either use NOP or continue to operate the OCS on their own by sending their own teams. Over the past 24 months, more and more centers elected to transition to NOP due to its more efficient cost profile, better clinical outcomes, and the ability to increase their transplant volumes without surgical fatigue of their staff.", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:10.562+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "4a5bfe87-cd51-4df8-b56f-e46b47200a9d", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "Your letter characterized our NOP program as a means to reduce access to the OCS technology and increase prices and profitability. This is not correct. Contrary to the Your letter accused TransMedics of pressuring hospitals to utilize our more expensive logistics. This couldn’t be further from the truth. TransMedics presents the logistics quotation to transplant centers using our NOP service. The transplant centers then have the final say on whether they want to use our services or not. We are confident, given the above efficient way of operating our fleet, and our cost-sharing model with transplant centers that our quotes are lower than competitors who use the outdated brokerage model. Your letter painted an inaccurate picture of the charter flight logistics for organ transplants in the US and accused TransMedics of creating a logistical network with newer aircrafts to unjustly increase cost on our clinical users. Again, this is not correct. Here are the facts. Transplant centers had the option to either use NOP or continue to operate the OCS on their own by sending their own teams. Over the past 24 months, more and more centers elected to transition to NOP due to its more efficient cost profile, better clinical outcomes, and the ability to increase their transplant volumes without surgical fatigue of their staff. — TransMedics CEO Waleed Hassanein", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-23 01:18:10+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-70f3-714d-84bf-6d2eecf07a5c", "parentComponentId": null }, { "bbox": { "h": 0.02, "w": 0.4, "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: https://investors.transmedics.com/static-files/efba44b7-1826-495f-9787-7805424f00f5", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:10.562+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "d32f7adb-b40c-4c39-8dd9-4388e37a8ebb", "parentComponentId": null }, { "bbox": { "h": 0.03, "w": 0.86, "x": 0.07, "y": 0.44 }, "kind": "title", "text": "TransMedics CEO Waleed Hassanein reply to Congressman Gosar’s letter Feb 26, 2024 - excerpts", "attrs": null, "canon": { "kind": { "name": "Title", "slug": "title", "status": "active", "canonId": "019de52c-f7dd-76d9-b848-b1f12bd85cf4", "version": 1, "description": "Slide title or headline." }, "tool": null, "subkind": { "name": "Subtitle", "slug": "subtitle", "status": "active", "canonId": "019de52c-fb09-739d-900c-815b0d9ac526", "version": 1, "description": null }, "framework": null }, "subkind": "subtitle", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:10.562+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "90d4b13c-928f-4928-874f-e78c980662dc", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [ { "matchId": "c68cc4a0-e146-4263-b9d6-2db9e2009afb", "evidence": "The slide explicitly contrasts an external allegation with a direct rebuttal from the CEO.", "framework": null, "confidence": 0.9, "extraction": { "at": "2026-05-02 20:12:10.562+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 57, "frameworkName": "expose_contradiction" } ], "arcBeats": [], "loops": [], "locked": true }, { "page": 58, "type": "tension", "title": "The slide uses a combination of legal theory and qualitative expert testimony to build a case for anticompetitive behavior.", "function": "expose_contradiction", "rawType": "expose_contradiction", "block": null, "metadata": { "slideType": "expose_contradiction", "slideTypeCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-124c-75aa-984a-0a3d0d8fc8df", "version": 1, "description": null }, "function": "expose_contradiction", "functionCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-171f-776f-887c-73edaff4cf9c", "version": 1, "description": null }, "density": "overcrowded", "densityScore": 78, "componentCount": 8, "textChars": 3405, "nDataPoints": 6, "notes": "The slide uses a combination of legal theory and qualitative expert testimony to build a case for anticompetitive behavior.", "elementsJson": [ "paragraph", "quote_block" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:12:11.299+00", "seconds": 5.544, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/58", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-58", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "Extortion occurs through the practice of “coercive tying” where the buyer is compelled to accept the tied service to accept the tying product, leading to higher costs and less choice.", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:01+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a975-3253aa7b738e", "parentComponentId": null }, { "bbox": null, "kind": "metric", "text": "consumable cost: $110,000-120,000", "attrs": null, "canon": { "kind": { "name": "Metric", "slug": "metric", "status": "active", "canonId": "019de52c-f923-73bf-8081-d0b1a8c5264d", "version": 1, "description": "Big-number or KPI value." }, "tool": { "name": "Quantification", "slug": "quantification", "status": "active", "bestFor": null, "canonId": "019dd9e1-47ab-72ce-a079-aab1f5299e88", "version": 1, "bodyDocId": null, "description": "Translating a claim into numbers, charts, or tables.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": "primary", "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:01+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a975-3976d6c20c40", "parentComponentId": null }, { "bbox": { "h": 0.35, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "paragraph", "text": "The statutory framework is well-established by the Sherman Act, Clayton Act, and the Federal Trade Commission Act; as well as in key case law that defines illegal tying and bundling such as International Salt, Jefferson Parish, and Eastman Kodak. Extortion occurs through the practice of “coercive tying” where the buyer is compelled to accept the tied service to accept the tying product, leading to higher costs and less choice. Thus, coercion and pricing are both central elements in anticompetition law. As a basic fact to gauge whether the pricing is extortion, we note that devices for kidneys cost $2,000 vs. TransMedics pumps at $70,000-$90,000 per consumable. Centers indicated that $110,000- $120,000 is the floor when the consumable is bundled with the NOP service, prior to including the Organ Procurement Organization’s charge of $50,000 to $70,000.", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:11.299+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "f99d5c86-8951-41e4-aff1-b5070fc6e6a0", "parentComponentId": null }, { "bbox": { "h": 0.08, "w": 0.86, "x": 0.07, "y": 0.45 }, "kind": "quote", "text": "Kidney perfusion pumps are a small fraction of TransMedics price. We have a cold perfusion pump for kidneys. They cost less than $2,000 each so that just gets absorbed into the OPO cost, but it's $2,000.", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:11.299+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "1bbb3fe4-11d4-47a0-b6fc-a5297b4e99c1", "parentComponentId": null }, { "bbox": { "h": 0.18, "w": 0.86, "x": 0.07, "y": 0.55 }, "kind": "quote", "text": "Floor is $110,000 to $120,000 prior to OPO organ acquisition fee. The bills from TransMedics could be $110,000-120,000, and that's in addition to the transplant center's organ acquisition fee that they're getting from the OPO, which in itself is $50,000 to $70,000. So, if you include the OPO's fee for the organ, think of it like buying a car, and TransMedics is the transport company for that car, the total cost out the door could be approaching $150,000-200,000 and the profit margin for a lot of the payors that we deal with is only about $300,000. So, you could be eroding a significant amount of your profit at the transplant center if you were using their NOP program soup-to-nuts.", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:11.299+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "63601d5a-db8b-4791-b4f2-d98a23d8b419", "parentComponentId": null }, { "bbox": { "h": 0.15, "w": 0.86, "x": 0.07, "y": 0.76 }, "kind": "quote", "text": "Over $100,000 with the NOP. A: The NOP, when it first came out, was described as $30,000 for the surgeon and the technician, and then you had to pay for the transportation of the organ. That was on top of the device cost. We were looking at the cost of an organ on the NOP of over $100,000 - that's not including the organ. That's the cost of just procuring the organ through the TransMedics program. Q: You said $100,000 for the NOP plus the cost of the disposable, the device? A: Correct. And then you added up the transportation and that's variable, but it's at least $10,000.", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:11.299+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "c3b6e671-f430-4d72-9fb4-8505514261b1", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "We have a cold perfusion pump for kidneys. They cost less than $2,000 each so that just gets absorbed into the OPO cost, but it's $2,000. — Transplant surgeon and transplant program director at a major academic center in Pennsylvania; The bills from TransMedics could be $110,000-120,000, and that’s in addition to the transplant center’s organ acquisition fee that they’re getting from the OPO, which in itself is $50,000 to $70,000. — Prominent surgeon, leadership role at a major West Coast academic transplant center; We were looking at the cost of an organ on the NOP of over $100,000 - that’s not including the organ. That’s the cost of just procuring the organ through the TransMedics program. — One of the top liver transplant surgeons in the world, based at a leading Midwest academic center", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:01+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a975-34748008a9e6", "parentComponentId": null }, { "bbox": { "h": 0.03, "w": 0.3, "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:11.299+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "b8d02e2d-2e5a-4b5e-b55f-d9e563974503", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [], "arcBeats": [], "loops": [], "locked": true }, { "page": 59, "type": "tension", "title": "The slide uses a Q&A format to highlight the discrepancy between pre-approval and post-approval pricing.", "function": "expose_contradiction", "rawType": "expose_contradiction", "block": null, "metadata": { "slideType": "expose_contradiction", "slideTypeCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-124c-75aa-984a-0a3d0d8fc8df", "version": 1, "description": null }, "function": "expose_contradiction", "functionCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-171f-776f-887c-73edaff4cf9c", "version": 1, "description": null }, "density": "dense", "densityScore": 56, "componentCount": 6, "textChars": 1880, "nDataPoints": 6, "notes": "The slide uses a Q&A format to highlight the discrepancy between pre-approval and post-approval pricing.", "elementsJson": [ "paragraph", "quote_block" ], "confidence": 0.95, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:12:08.528+00", "seconds": 2.763, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/59", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-59", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "A transplant cardiologist at an Ivy League center stated that the pre-approval price per consumable went up by 3 or 4X from $24 to $25,000 but to now $80 to $90,000 – before including the NOP service.", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:00+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a974-dd8104dcf4cd", "parentComponentId": null }, { "bbox": null, "kind": "metric", "text": "price per consumable: $80,000", "attrs": null, "canon": { "kind": { "name": "Metric", "slug": "metric", "status": "active", "canonId": "019de52c-f923-73bf-8081-d0b1a8c5264d", "version": 1, "description": "Big-number or KPI value." }, "tool": { "name": "Quantification", "slug": "quantification", "status": "active", "bestFor": null, "canonId": "019dd9e1-47ab-72ce-a079-aab1f5299e88", "version": 1, "bodyDocId": null, "description": "Translating a claim into numbers, charts, or tables.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": "primary", "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:00+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a974-e5f6a3b73f5c", "parentComponentId": null }, { "bbox": { "h": 0.35, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "paragraph", "text": "However, customers told us that $100,000+ is merely a floor and that the price can explode to $300,000 to $400,000 per transplant run when the device is bundled with the NOP and if TransMedics sends multiple jets to run up the charge, an outrageous practice. according to centers who stated they have received such invoices. Moreover, as Congressman Gosar alleged, users stated that TransMedics spiked the price after FDA approval. A transplant cardiologist at an Ivy League center stated that the pre-approval price per consumable went up by 3 or 4X from $24 to $25,000 but to now $80 to $90,000 – before including the NOP service.", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:08.528+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "414115d2-68ca-4867-bf0a-0ecc0948fb5f", "parentComponentId": null }, { "bbox": { "h": 0.25, "w": 0.86, "x": 0.07, "y": 0.41 }, "kind": "quote", "text": "Price per device consumable spiked after FDA approval. A: 'I actually looked into this a few months ago; it's like the price increased significantly. When we were doing it ourselves, I think it was around $20 or $30,000 per disposable. And now, I think bundled together, it's getting closer to $80 to 90,000.' Q: 'The disposable was how much during the trial?' A: 'It was mid-20s, I think, 24-25.' Q: 'Which period was the trial?' A: '2020, and then it continued after as protocol, which was 2021. The cost was nowhere near what it is now.' – Transplant cardiologist at a major Ivy League academic center", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:08.528+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "93bd9780-1f62-45fd-a68c-b33cce1c5371", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "I actually looked into this a few months ago; it's like the price increased significantly. When we were doing it ourselves, I think it was around $20 or $30,000 per disposable. And now, I think bundled together, it's getting closer to $80 to 90,000. ... The cost was nowhere near what it is now. — Transplant cardiologist at a major Ivy League academic center", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:00+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a974-e0513127f3bf", "parentComponentId": null }, { "bbox": { "h": 0.02, "w": 0.3, "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:08.528+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "e4498314-84e1-4cff-8af0-eb737f36f0c4", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [ { "matchId": "91eeea26-150a-4a1d-88dc-602412d809d8", "evidence": "The slide explicitly frames the content as an allegation of price gouging and 'outrageous practice' to expose potential corporate misconduct.", "framework": null, "confidence": 0.9, "extraction": { "at": "2026-05-02 20:12:08.528+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 59, "frameworkName": "fraud-exposure" } ], "arcBeats": [], "loops": [], "locked": true }, { "page": 60, "type": "tension", "title": "The slide uses direct quotes to build a case for anticompetitive behavior, specifically focusing on the forced bundling of procurement services with product usa", "function": "name_villain", "rawType": "villain_critique", "block": null, "metadata": { "slideType": "villain_critique", "slideTypeCanon": { "name": "Villain critique", "slug": "villain_critique", "status": "active", "canonId": "019de52d-10bc-7136-bf20-09de59d17447", "version": 1, "description": null }, "function": "name_villain", "functionCanon": { "name": "Name villain", "slug": "name_villain", "status": "active", "canonId": "019de52d-1746-70d6-bc58-5eeaf5865526", "version": 1, "description": null }, "density": "balanced", "densityScore": 48, "componentCount": 6, "textChars": 1701, "nDataPoints": 0, "notes": "The slide uses direct quotes to build a case for anticompetitive behavior, specifically focusing on the forced bundling of procurement services with product usage.", "elementsJson": [ "paragraph", "quote_block", "footnote" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:12:10.426+00", "seconds": 4.554, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/60", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-60", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "The charges were exponentially higher due to the forced tying of the device to the service – classic anticompetitive conduct.", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-23 01:18:10+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-70f3-714d-84bf-8153e309898f", "parentComponentId": null }, { "bbox": { "h": 0.25, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "paragraph", "text": "Surgeons and transplant administrators we spoke with – including TransMedics highest volume users – assailed the pricing as extortionate and predatory. They disputed the CEO’s claim that the bundled NOP service was cheaper than traditional air transport or resulted in any cost saving, and stated that the charges were exponentially higher due to the forced tying of the device to the service – classic anticompetitive conduct.", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:10.426+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "999fdc1e-cc35-4a56-94dc-f17ec4813b93", "parentComponentId": null }, { "bbox": { "h": 0.18, "w": 0.86, "x": 0.07, "y": 0.75 }, "kind": "quote", "text": "“Weird predilection” in pushing their aircraft; cist is “unnecessary”. What’s been a little bit questionable from my own personal experience is there is this weird predilection that they have to push you towards using their modes of transportation... the additional cost is an annoyance when it’s unnecessary to be spent.", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:10.426+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "31f58483-8ce9-4398-8039-0c6646373f23", "parentComponentId": null }, { "bbox": { "h": 0.22, "w": 0.86, "x": 0.07, "y": 0.51 }, "kind": "quote", "text": "“Persistent” in forcing their procurement service and “egregious” pricing. I’m also a transplant director... they are mandating that if you are going to use our product, you have to use our planes and procurement... their price is so egregious that a lot of programs, including ours, can’t or won’t do it.", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:10.426+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "a8f4878a-ab76-4c89-be88-6c57e3834788", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "“very strongly want you to use their procurement service”; that “their new contracts, they are mandating that if you are going to use our product, you have to use our planes and procurement”; that “they’re persistent in pushing” their aircraft and their “price is so egregious that a lot of programs, including ours can’t or won’t do it” – “the additional cost is an annoyance when it’s unnecessary to be spent.” — Cardiac transplant surgeon at a major Midwest center", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-23 01:18:10+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-70f3-714d-84bf-8726216e387f", "parentComponentId": null }, { "bbox": { "h": 0.03, "w": 0.25, "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:10.426+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "921c6836-6df3-47e5-951d-01ce58b30b68", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [ { "matchId": "38b21427-c50c-4183-9777-6a4426901aed", "evidence": "The slide frames TransMedics as a predatory entity through expert testimonials.", "framework": null, "confidence": 0.9, "extraction": { "at": "2026-05-02 20:12:10.426+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 60, "frameworkName": "antagonist-introduction" } ], "arcBeats": [], "loops": [], "locked": true }, { "page": 61, "type": "tension", "title": "The slide uses direct quotes from KOLs to build a case against the company's pricing model.", "function": "name_villain", "rawType": "villain_critique", "block": null, "metadata": { "slideType": "villain_critique", "slideTypeCanon": { "name": "Villain critique", "slug": "villain_critique", "status": "active", "canonId": "019de52d-10bc-7136-bf20-09de59d17447", "version": 1, "description": null }, "function": "name_villain", "functionCanon": { "name": "Name villain", "slug": "name_villain", "status": "active", "canonId": "019de52d-1746-70d6-bc58-5eeaf5865526", "version": 1, "description": null }, "density": "overcrowded", "densityScore": 81, "componentCount": 10, "textChars": 1542, "nDataPoints": 6, "notes": "The slide uses direct quotes from KOLs to build a case against the company's pricing model.", "elementsJson": [ "paragraph", "quote_block" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:12:09.219+00", "seconds": 3.339, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/61", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-61", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": { "h": 0.03, "w": 0.85, "x": 0.07, "y": 0.69 }, "kind": "callout", "text": "Other organ procurement services are at more reasonable cost; $20-35,000 versus $130-140,000", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": null, "subkind": { "name": "Primary callout", "slug": "primary", "status": "active", "canonId": "019de52c-fbd1-70eb-a9ce-8997f8674c1d", "version": 1, "description": null }, "framework": null }, "subkind": "primary", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:09.219+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "1848ad5e-12f4-4962-9440-93f6e3d5b5f0", "parentComponentId": null }, { "bbox": { "h": 0.03, "w": 0.85, "x": 0.07, "y": 0.51 }, "kind": "callout", "text": "NOP air transport cost is about double versus what centers pay when they use a la carte charter services", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": null, "subkind": { "name": "Primary callout", "slug": "primary", "status": "active", "canonId": "019de52c-fbd1-70eb-a9ce-8997f8674c1d", "version": 1, "description": null }, "framework": null }, "subkind": "primary", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:09.219+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "3309d21f-6595-4df0-b14a-d42cb17a5a6e", "parentComponentId": null }, { "bbox": null, "kind": "callout", "text": "Their transportation charge has gone up because TransMedics has their transportation network, and their prices are higher than what we pay for our own planes that we contract privately.", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:01+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a975-4b5d81864122", "parentComponentId": null }, { "bbox": null, "kind": "metric", "text": "hourly flight cost: $8,000", "attrs": null, "canon": { "kind": { "name": "Metric", "slug": "metric", "status": "active", "canonId": "019de52c-f923-73bf-8081-d0b1a8c5264d", "version": 1, "description": "Big-number or KPI value." }, "tool": { "name": "Quantification", "slug": "quantification", "status": "active", "bestFor": null, "canonId": "019dd9e1-47ab-72ce-a079-aab1f5299e88", "version": 1, "bodyDocId": null, "description": "Translating a claim into numbers, charts, or tables.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": "primary", "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:01+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a975-52d4f1d07c69", "parentComponentId": null }, { "bbox": { "h": 0.35, "w": 0.85, "x": 0.07, "y": 0.14 }, "kind": "paragraph", "text": "The hourly flight charges are about double, according to one of the top liver transplant surgeons in the world - a highly published and widely-followed KOL...", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:09.219+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "ba79d15a-82ff-4e5f-8b4e-b917ae4cf269", "parentComponentId": null }, { "bbox": { "h": 0.12, "w": 0.85, "x": 0.07, "y": 0.55 }, "kind": "paragraph", "text": "\"Their transportation charge has gone up because TransMedics has their transportation network... we were paying about $4500 an hour... I estimate it's around $7500 to $8500 per hour.\"", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:09.219+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "dcd829be-0240-49f2-8086-ea3b5fccb27f", "parentComponentId": null }, { "bbox": { "h": 0.18, "w": 0.85, "x": 0.07, "y": 0.73 }, "kind": "paragraph", "text": "\"There's a program on the East Coast... they do it at a much more reasonable price because it's not associated with OCS... it's $130,000 to $140,000... for us to charter a jet and fly, it's $20,000 to $35,000.\"", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:09.219+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "ebccd455-bd99-4d39-a7ce-ceca4724946f", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "their prices are higher than what we pay for our own planes that we contract privately. ... I estimate it's around $7500 to $8500 per hour. — One of the top liver transplant surgeons in the world, based at a leading Midwest academic center. ... a much more reasonable price because it’s not associated with OCS. ... they’re not buying the jets…they’re using charters just like we use currently. — Cardiac transplant surgeon at a major Midwest academic center", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:01+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a975-4c5302f98c1b", "parentComponentId": null }, { "bbox": { "h": 0.02, "w": 0.3, "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:09.219+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "24c08486-405e-4c7c-87d8-76ea16a827b2", "parentComponentId": null }, { "bbox": { "h": 0.06, "w": 0.85, "x": 0.07, "y": 0.07 }, "kind": "title", "text": "TransMedics bundled pricing scheme is,we believe, inherently coercive.", "attrs": null, "canon": { "kind": { "name": "Title", "slug": "title", "status": "active", "canonId": "019de52c-f7dd-76d9-b848-b1f12bd85cf4", "version": 1, "description": "Slide title or headline." }, "tool": null, "subkind": { "name": "Headline", "slug": "headline", "status": "active", "canonId": "019de52c-fae1-7463-9a7c-d60668eced0d", "version": 1, "description": null }, "framework": null }, "subkind": "headline", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:09.219+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "044f74e1-c1bd-4e1f-8c87-2a23ee2bf143", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [ { "matchId": "086322a1-96a6-4ece-ae59-89298940fe36", "evidence": "Uses quotes from 'top liver transplant surgeons' and 'KOLs' to validate the argument.", "framework": null, "confidence": 0.9, "extraction": { "at": "2026-05-02 20:12:09.219+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 61, "frameworkName": "authority-citation" } ], "arcBeats": [], "loops": [], "locked": true }, { "page": 62, "type": "tension", "title": "The slide uses direct quotes from industry experts to frame the company's pricing as predatory and its leadership as arrogant.", "function": "expose_contradiction", "rawType": "testimonial", "block": null, "metadata": { "slideType": "testimonial", "slideTypeCanon": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52d-0a2d-7782-8a48-7e84df92cc97", "version": 1, "description": null }, "function": "expose_contradiction", "functionCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-171f-776f-887c-73edaff4cf9c", "version": 1, "description": null }, "density": "dense", "densityScore": 58, "componentCount": 6, "textChars": 2909, "nDataPoints": 1, "notes": "The slide uses direct quotes from industry experts to frame the company's pricing as predatory and its leadership as arrogant.", "elementsJson": [ "paragraph", "quote_block", "footnote" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 21:25:52.067+00", "seconds": 7.131, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/62", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-62", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "We cannot recall physicians thrashing the pricing of a medical product as harshly as they do with respect to TransMedics.", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:02+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a975-92bbce114c2f", "parentComponentId": null }, { "bbox": { "h": 0.35, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "paragraph", "text": "We cannot recall physicians thrashing the pricing of a medical product as harshly as they do with respect to TransMedics. A surgeon and director of a leading transplant center in the Northeast asked “why should it cost $70,000 to $80,000 for disposables” when they are just “plastic tubings and plastic containers…it is, no question, overpriced.” A transplant hepatologist who is one of the highest-volume users and who believe to be on the dole via kickbacks was nonetheless unvarnished when he spoke with us, calling it “ridiculously expensive…I could argue predatory”; “outrageously overpriced”; “completely unreasonable, to be very, very clear”; “yeah, it is pretty polarizing”. Regarding the CEO Waleed Hassanein, he noted “a level of arrogance…I think they are generally known to be fairly assertive and aggressive.”", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:25:52.067+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "f43c7d16-357b-4a94-b448-34ef9b65ebfc", "parentComponentId": null }, { "bbox": { "h": 0.25, "w": 0.86, "x": 0.07, "y": 0.65 }, "kind": "quote", "text": "High volume user slammed the pricing as “outrageous”. “It is a ridiculously expensive solution. I could argue predatory, perhaps…I think my biggest issue with it is that it is outrageously overpriced…should there be more transparency in contracting, etc.? Probably, yeah…Yeah, it is pretty polarizing…I don’t like the price. I think the price is completely unreasonable, to be very, very clear…I have attended national presentations where folks from TransMedics, Waleed, have presented data…there is a level of arrogance…I think they are generally known to be fairly assertive and aggressive.” - Transplant hepatologist and director of the liver program at a Midwest academic center; one of TransMedics highest volume users", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:25:52.067+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "719fa7f7-9657-4686-a2ab-cab5add82140", "parentComponentId": null }, { "bbox": { "h": 0.18, "w": 0.86, "x": 0.07, "y": 0.45 }, "kind": "quote", "text": "“No question, overpriced” for disposables that are just plastic tubing. “They’re first on the market, so they have a monopoly, and they priced it like a monopoly because why should it cost $70,000-80,000 for disposables? The disposables are essentially plastic tubings and plastic containers and cartridges, and that’s more than the cost of a brand-new luxury car that you’re paying for a set of things that you throw in the garbage, essentially. It is, no question, overpriced.” - Transplant surgeon and transplant program director at a leading Northeast academic center", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:25:52.067+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "829b9826-36a1-4024-81dc-8ff624eb9f4b", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "\"why should it cost $70,000 to $80,000 for disposables\" when they are just \"plastic tubings and plastic containers...it is, no question, overpriced.\" — Surgeon and director of a leading transplant center in the Northeast. \"ridiculously expensive...I could argue predatory\"; \"outrageously overpriced\"; \"completely unreasonable, to be very, very clear\"; \"yeah, it is pretty polarizing\". Regarding the CEO Waleed Hassanein, he noted \"a level of arrogance...I think they are generally known to be fairly assertive and aggressive.\" — Transplant hepatologist and director of the liver program at a Midwest academic center.", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:02+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a975-966ba7b136a4", "parentComponentId": null }, { "bbox": { "h": 0.03, "w": 0.3, "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:25:52.067+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "ed364e2e-bc8f-4826-a9aa-dfec807f5bc1", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [], "arcBeats": [], "loops": [], "locked": true }, { "page": 63, "type": "tension", "title": "Includes direct quotes from a transplant administrator/executive at MGH.", "function": "expose_contradiction", "rawType": "expose_contradiction", "block": null, "metadata": { "slideType": "expose_contradiction", "slideTypeCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-124c-75aa-984a-0a3d0d8fc8df", "version": 1, "description": null }, "function": "expose_contradiction", "functionCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-171f-776f-887c-73edaff4cf9c", "version": 1, "description": null }, "density": "dense", "densityScore": 68, "componentCount": 7, "textChars": 3899, "nDataPoints": 1, "notes": "Includes direct quotes from a transplant administrator/executive at MGH.", "elementsJson": [ "paragraph", "quote_block" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:12:14.254+00", "seconds": 8.251, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/63", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-63", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "MGH corroborated key aspects of TransMedics bundling and extortion scheme", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-23 01:18:10+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-70f3-714d-84bf-99ebe3dcafc7", "parentComponentId": null }, { "bbox": { "h": 0.35, "w": 0.86, "x": 0.07, "y": 0.11 }, "kind": "paragraph", "text": "MGH is one of the leading medical centers and transplant programs in the world, and may have a longer and deeper history with TransMedics than any other program given their physical proximity. An MGH surgeon was the lead author on the company’s pivotal PROTECT trial. We spoke with a transplant administrator, as well as a transplant hepatologist in a leadership role, who confirmed key aspects of the scheme and the dubious business practices that have led them to sour on the relationship. They stated that they are forced to use the NOP service and that the pricing is much more expensive as a result of the bundling: “that’s the only way you can use it”; “we’re kind of forced to...we don’t really have an option”; “two years ago TransMedics said...we’re going to dictate the terms of the utilization of our pump...we are not going to let transplant centers buy our pump”; “they have to use our service...so that’s why it’s so much more expensive.”", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:14.254+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "96a4acd7-f74a-4105-b4e8-ac512e8e5292", "parentComponentId": null }, { "bbox": { "h": 0.35, "w": 0.86, "x": 0.07, "y": 0.55 }, "kind": "quote", "text": "Q: “For those liver cases that you use TransMedics, are you also using their NOP service?” A: “That’s the only way you can use it - there is a model where, our center has three surgeons trained on putting livers on pump...so, we do have three surgeons trained for a TransMedics pump. Of the 38 OCS pumps that we’ve done, our surgeons have done only two of them, to give you an idea.” Q: “One thing that I’ve heard from a lot of people is that they’re not even allowed to train on the pump. That if you want to use the pump, you have to use their NOP service. So, you’re saying that you use it because you actually don’t even have any other option even if you wanted to?” A: “Yeah, financially, we’re kind of forced in that way. We don’t really have an option because the pumps reside with TransMedics. So, they have to send a team anyway...That there’s no what we call back-to-base model, where we own the pump, we can bring a liver back here.. So, two years ago, TransMedics said we’re going all in, and we’re going to not only set the pricing for our pump but we’re going to dictate the terms of the utilization of our pump, which includes we’re going to use our own surgeon, we’re going to use our own perfusionists, we are not going to let transplant centers buy our pump. Not only do they have to use our pumps and the cartridges and the equipment but they have to use our service line. So that’s why it’s so much more expensive than the other pump options.” – Veteran transplant administrator/executive at Massachusetts General Hospital", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:14.254+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "5db79f55-b5d0-45f1-9cc0-bd85f37de96e", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "“That’s the only way you can use it - there is a model where, our center has three surgeons trained on putting livers on pump...so, we do have three surgeons trained for a TransMedics pump. Of the 38 OCS pumps that we’ve done, our surgeons have done only two of them, to give you an idea.”; “Yeah, financially, we’re kind of forced in that way. We don’t really have an option because the pumps reside with TransMedics. So, they have to send a team anyway...That there’s no what we call back-to-base model, where we own the pump, we can bring a liver back here.. So, two years ago, TransMedics said we’re going all in, and we’re going to not only set the pricing for our pump but we’re going to dictate the terms of the utilization of our pump, which includes we’re going to use our own surgeon, we’re going to use our own perfusionists, we are not going to let transplant centers buy our pump. Not only do they have to use our pumps and the cartridges and the equipment but they have to use our service line. So that’s why it’s so much more expensive than the other pump options.” — Veteran transplant administrator/executive at Massachusetts General Hospital", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-23 01:18:10+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-70f3-714d-84bf-9cb12a55d437", "parentComponentId": null }, { "bbox": { "h": 0.02, "w": 0.25, "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:14.254+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "e9e257f7-4060-45cb-97b9-2053299cb5cb", "parentComponentId": null }, { "bbox": { "h": 0.02, "w": 0.55, "x": 0.07, "y": 0.52 }, "kind": "title", "text": "MGH corroborated key aspects of TransMedics bundling and extortion scheme", "attrs": null, "canon": { "kind": { "name": "Title", "slug": "title", "status": "active", "canonId": "019de52c-f7dd-76d9-b848-b1f12bd85cf4", "version": 1, "description": "Slide title or headline." }, "tool": null, "subkind": { "name": "Action title", "slug": "action-title", "status": "active", "canonId": "019de52c-fb31-734c-a0f5-a3935b73135d", "version": 1, "description": null }, "framework": null }, "subkind": "action-title", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:14.254+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "40505e43-ecbc-463d-b1e4-d2c8aae9c540", "parentComponentId": null }, { "bbox": { "h": 0.03, "w": 0.45, "x": 0.07, "y": 0.07 }, "kind": "title", "text": "Case study 1: Massachusetts General Hospital", "attrs": null, "canon": { "kind": { "name": "Title", "slug": "title", "status": "active", "canonId": "019de52c-f7dd-76d9-b848-b1f12bd85cf4", "version": 1, "description": "Slide title or headline." }, "tool": null, "subkind": { "name": "Headline", "slug": "headline", "status": "active", "canonId": "019de52c-fae1-7463-9a7c-d60668eced0d", "version": 1, "description": null }, "framework": null }, "subkind": "headline", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:14.254+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "5899897e-860a-4ca0-b107-92df7cfca43b", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [], "arcBeats": [], "loops": [], "locked": true }, { "page": 64, "type": "tension", "title": "The slide uses direct quotes from MGH staff to argue that TransMedics' business model is built on control rather than efficiency.", "function": "expose_contradiction", "rawType": "testimonial", "block": null, "metadata": { "slideType": "testimonial", "slideTypeCanon": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52d-0a2d-7782-8a48-7e84df92cc97", "version": 1, "description": null }, "function": "expose_contradiction", "functionCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-171f-776f-887c-73edaff4cf9c", "version": 1, "description": null }, "density": "dense", "densityScore": 73, "componentCount": 8, "textChars": 3829, "nDataPoints": 0, "notes": "The slide uses direct quotes from MGH staff to argue that TransMedics' business model is built on control rather than efficiency.", "elementsJson": [ "paragraph", "quote_block", "footnote" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:12:10.121+00", "seconds": 3.978, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/64", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-64", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "MGH stated the NOP service is about control, not cost savings or efficiencies – “as an institution, you have to start asking...is this viable?”", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:01+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a975-6061212e5ccc", "parentComponentId": null }, { "bbox": { "h": 0.35, "w": 0.85, "x": 0.07, "y": 0.12 }, "kind": "paragraph", "text": "MGH stated the NOP service is about control, not cost savings or efficiencies – “as an institution, you have to start asking...is this viable?” Shockingly, the transplant administrator indicated that TransMedics logistics are a circus where aircraft or staff may be unavailable, jeopardizing MGH’s ability to procure the organ. However, TransMedics allegedly remains inflexible even in such emergencies and forces the center to sit on its hands until their plane is available, as a condition for accessing the device. In those situations, MGH has to find its own plane for its procurement team but still pay for a second plane TransMedics sends with its device operator – “it’s about control...if you can control the surgeon, the team, the airplane – everything – as a consumer, I’m stuck”; “sometimes, we can’t even get a plane because of the delay...where we have to then field another jet because we’ve got 90 minutes...that adds to the additional cost.”", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:10.121+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "8b107dc3-78a9-42db-830a-9327ff1f0e28", "parentComponentId": null }, { "bbox": { "h": 0.15, "w": 0.85, "x": 0.07, "y": 0.6 }, "kind": "quote", "text": "“I think it’s about control. So, if you can control the surgeon, the team, the airplane - everything - as a consumer, I’m stuck. I might know what the cost would be, but then there are all these delays. You mentioned the two-hour additional warm ischemic time—that eats into my cost. Sometimes, we can’t even get a plane because of the delay in the procuring arena where we have to then field another jet because we’ve got 90 minutes. So, that adds to the additional cost, too. But I would say when it comes down to why their team needs to be the one and only to make the decision, I think that’s a control thing. I think that’s them making the call. And I have no control over that.” – Veteran transplant administrator/executive at Massachusetts General Hospital", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:10.121+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "7b0ac965-c8a6-4748-9cfb-fde99e4d1e4b", "parentComponentId": null }, { "bbox": { "h": 0.12, "w": 0.85, "x": 0.07, "y": 0.78 }, "kind": "quote", "text": "MGH asking “is this viable?” “...so there may be a feeling of being kind of forced or leveraged into taking on that service. At some point, the cost, the economic analysis—I think they’re bordering on eating into all of the margin or most of the margin that would be gotten from doing another case of liver transplantation. I think that when you start pushing up against that, at least as an institution, you have to start asking the question, is this viable?” – Transplant hepatologist in a leadership role at Massachusetts General Hospital", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:10.121+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "c08d56c0-85a3-435b-8923-99de7e4317e3", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "“I think it’s about control. So, if you can control the surgeon, the team, the airplane - everything - as a consumer, I’m stuck. I might know what the cost would be, but then there are all these delays. Sometimes, we can’t even get a plane because of the delay in the procuring arena where we have to then field another jet because we’ve got 90 minutes. So, that adds to the additional cost, too. But I would say when it comes down to why their team needs to be the one and only to make the decision, I think that’s a control thing. I think that’s them making the call. And I have no control over that.” — Veteran transplant administrator/executive at Massachusetts General Hospital; “...so there may be a feeling of being kind of forced or leveraged into taking on that service. At some point, the cost, the economic analysis—I think they’re bordering on eating into all of the margin or most of the margin that would be gotten from doing another case of liver transplantation. I think that when you start pushing up against that, at least as an institution, you have to start asking the question, is this viable?” — Transplant hepatologist in a leadership role at Massachusetts General Hospital", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:01+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a975-6484abc13878", "parentComponentId": null }, { "bbox": { "h": 0.02, "w": 0.3, "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:10.121+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "3b5e23fe-7986-417f-9ef4-4ff36c7c0153", "parentComponentId": null }, { "bbox": { "h": 0.05, "w": 0.85, "x": 0.07, "y": 0.55 }, "kind": "title", "text": "Bundling is to lock in and control customers; NOP service and logistics are not particularly efficient and increase cost", "attrs": null, "canon": { "kind": { "name": "Title", "slug": "title", "status": "active", "canonId": "019de52c-f7dd-76d9-b848-b1f12bd85cf4", "version": 1, "description": "Slide title or headline." }, "tool": null, "subkind": { "name": "Action title", "slug": "action-title", "status": "active", "canonId": "019de52c-fb31-734c-a0f5-a3935b73135d", "version": 1, "description": null }, "framework": null }, "subkind": "action-title", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:10.121+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "0a60afea-3f3e-49ca-83d2-8c9a5ac7c573", "parentComponentId": null }, { "bbox": { "h": 0.04, "w": 0.85, "x": 0.07, "y": 0.07 }, "kind": "title", "text": "Case study 1: Massachusetts General Hospital (cont’d)", "attrs": null, "canon": { "kind": { "name": "Title", "slug": "title", "status": "active", "canonId": "019de52c-f7dd-76d9-b848-b1f12bd85cf4", "version": 1, "description": "Slide title or headline." }, "tool": null, "subkind": { "name": "Headline", "slug": "headline", "status": "active", "canonId": "019de52c-fae1-7463-9a7c-d60668eced0d", "version": 1, "description": null }, "framework": null }, "subkind": "headline", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:10.121+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "f78c3837-f8ef-4205-a0b2-313061b12816", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [], "arcBeats": [], "loops": [], "locked": true }, { "page": 65, "type": "tension", "title": "The slide uses a Q&A format to highlight alleged anti-competitive behavior (tying/bundling).", "function": "expose_contradiction", "rawType": "expose_contradiction", "block": null, "metadata": { "slideType": "expose_contradiction", "slideTypeCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-124c-75aa-984a-0a3d0d8fc8df", "version": 1, "description": null }, "function": "expose_contradiction", "functionCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-171f-776f-887c-73edaff4cf9c", "version": 1, "description": null }, "density": "dense", "densityScore": 66, "componentCount": 7, "textChars": 2814, "nDataPoints": 1, "notes": "The slide uses a Q&A format to highlight alleged anti-competitive behavior (tying/bundling).", "elementsJson": [ "paragraph", "quote_block", "footnote" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:12:10.259+00", "seconds": 3.613, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/65", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-65", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": { "h": 0.04, "w": 0.86, "x": 0.07, "y": 0.41 }, "kind": "callout", "text": "MGH anecdotes describe TransMedics holding the device “hostage” to force them to use the NOP", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": null, "subkind": { "name": "Primary callout", "slug": "primary", "status": "active", "canonId": "019de52c-fbd1-70eb-a9ce-8997f8674c1d", "version": 1, "description": null }, "framework": null }, "subkind": "primary", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:10.259+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "f6b4ab66-a378-47f3-a0a5-050195e9a947", "parentComponentId": null }, { "bbox": null, "kind": "callout", "text": "It’s primarily related to locking us in in order to use the OCS team, flights, their modules, and everything, versus using our own.", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:02+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a975-7b664ab0e1da", "parentComponentId": null }, { "bbox": { "h": 0.25, "w": 0.86, "x": 0.07, "y": 0.12 }, "kind": "paragraph", "text": "MGH provided anecdotes which we think the FTC and/or DOJ would view as textbook coercion – “they’re holding [the device] hostage” - when its procurement team was “mobilized and everything ready to go” but TransMedics would say “well, we can’t get the module to you in time.” Given the requirement that only TransMedics staff can operate the device, the company would allegedly say the only alternative is to fly a separate TransMedics plane just for the device. MGH would push back and offer to send an Uber to their facility to get the device, only to be told “oh no, that’s not how we do things” – “it’s primarily related to locking us in to use the OCS team, flights, their modules”; “I’m stuck...literally, I’m stuck...I literally don’t have the device and they’re holding it hostage.”", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:10.259+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "54d3e15f-0602-4318-b289-3bafa0602388", "parentComponentId": null }, { "bbox": { "h": 0.45, "w": 0.86, "x": 0.07, "y": 0.46 }, "kind": "paragraph", "text": "Q: “Are saying TransMedics can’t activate and get everybody there in time, or that their surgeons are unskilled and incompetent? Or both?”\n\nA: “It’s both. Let me just separate. The first part wasn’t related to delays based on the skillset and experience of the procuring team. It’s primarily related to locking us in in order to use the OCS team, flights, their modules, and everything, versus using our own. For instance, if we were to work on trying to get our team all mobilized and everything ready to go and they’re saying, well, we can’t get the module to you in time. So, we’re just going to fly the person out from our facility over to wherever the hospital is, but you’re going to have to eat that cost. And I’m like, why would we ever do that? I will literally have one of my surgeons take an Uber over to your facility, bring it back, meet you at Logan, and then they’ll go on the flight. “Oh no, that’s not how we do things.” Well, how about you get your tech to then take the Uber with the module over to either my hospital, where the team is waiting, or to get to the airport? “Yeah, that’s going to cost $7000.” And I’m like that right there is going to cost $7000? “Yes. You have one hour to give us your answer.” That’s how the conversation goes. So, I’m stuck. Literally, I’m stuck. I literally don’t have the device and they’re holding it hostage, so I have to then say I’m going to open it up, $7000, come on over.” – Veteran transplant administrator/executive at Massachusetts General Hospital", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:10.259+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "b0921d2e-af46-4c6b-922a-fa170f9273d0", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "I’m stuck...literally, I’m stuck...I literally don’t have the device and they’re holding it hostage. — Veteran transplant administrator/executive at Massachusetts General Hospital", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:02+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a975-7c94d8f5bf45", "parentComponentId": null }, { "bbox": { "h": 0.02, "w": 0.3, "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:10.259+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "ec0bbe25-3f8d-40f2-9e77-31fa3c17c00a", "parentComponentId": null }, { "bbox": { "h": 0.04, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "title", "text": "Case study 1: Massachusetts General Hospital (cont’d)", "attrs": null, "canon": { "kind": { "name": "Title", "slug": "title", "status": "active", "canonId": "019de52c-f7dd-76d9-b848-b1f12bd85cf4", "version": 1, "description": "Slide title or headline." }, "tool": null, "subkind": { "name": "Headline", "slug": "headline", "status": "active", "canonId": "019de52c-fae1-7463-9a7c-d60668eced0d", "version": 1, "description": null }, "framework": null }, "subkind": "headline", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:10.259+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "d2962f74-b209-4ce6-bd2e-f9b692d079bd", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [], "arcBeats": [], "loops": [], "locked": true }, { "page": 66, "type": "tension", "title": "The slide uses a Q&A format to present expert testimony as evidence of the company's alleged predatory practices.", "function": "name_villain", "rawType": "villain_critique", "block": null, "metadata": { "slideType": "villain_critique", "slideTypeCanon": { "name": "Villain critique", "slug": "villain_critique", "status": "active", "canonId": "019de52d-10bc-7136-bf20-09de59d17447", "version": 1, "description": null }, "function": "name_villain", "functionCanon": { "name": "Name villain", "slug": "name_villain", "status": "active", "canonId": "019de52d-1746-70d6-bc58-5eeaf5865526", "version": 1, "description": null }, "density": "dense", "densityScore": 64, "componentCount": 7, "textChars": 3259, "nDataPoints": 0, "notes": "The slide uses a Q&A format to present expert testimony as evidence of the company's alleged predatory practices.", "elementsJson": [ "paragraph", "quote_block" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:12:10.593+00", "seconds": 3.609, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/66", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-66", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": { "h": 0.04, "w": 0.86, "x": 0.07, "y": 0.47 }, "kind": "callout", "text": "Centers indicate that the TransMedics NOP is inefficient and marred by delays that jeopardize organ procurement", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": null, "subkind": { "name": "Primary callout", "slug": "primary", "status": "active", "canonId": "019de52c-fbd1-70eb-a9ce-8997f8674c1d", "version": 1, "description": null }, "framework": null }, "subkind": "primary", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:10.593+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "c1ff12c4-9e7c-407d-acc3-bfc25ee41213", "parentComponentId": null }, { "bbox": null, "kind": "callout", "text": "The “delays” appear intentional to force the center to pay for a second TransMedics plane versus traveling with the procurement team, as well as driven by incompetence that may result in stranded and lost organs.", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:05+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a978-4bdb1769c822", "parentComponentId": null }, { "bbox": { "h": 0.22, "w": 0.86, "x": 0.07, "y": 0.22 }, "kind": "paragraph", "text": "MGH painted the logistics as amateurish and marred by delays and bottlenecks, in contrast to MGH’s in-house ability to manage the complex “orchestration” of staff and resources to procure an organ. The “delays” appear intentional to force the center to pay for a second TransMedics plane versus traveling with the procurement team, as well as driven by incompetence that may result in stranded and lost organs – “...and they’re dragging their feet...and here we are scrambling...to get the orchestration done, but we ended up finding out TransMedics has been ‘working on certain things’ for hours...potentially the organ will not be used....”", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:10.593+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "66f29d38-14f4-4fae-ae78-c2f166d46bf7", "parentComponentId": null }, { "bbox": { "h": 0.42, "w": 0.86, "x": 0.07, "y": 0.52 }, "kind": "quote", "text": "Q: “You made a comment that’s consistent with what I’ve heard from others about delays... they’re basically holding organs hostage, somebody used the word ‘extortion.’ Walk me through what you were referring to.” A: “...It’s an orchestration, and there’s an art to it. When it comes to TransMedics...and we’re going to need the team...and they’re dragging their feet. And here we are scrambling to try to get to that timeline of can we get the team? ...we ended up finding out TransMedics has been “working on certain things” for hours, and then we get notified, and so the only last-ditch effort before we forego the organ and potentially the organ will not be used because it might be up in eastern Maine...then there’s no other option other than eat the cost.” – Veteran transplant administrator/executive at Massachusetts General Hospital", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:10.593+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "ad172896-8faa-4a95-90df-e9f30e1e4739", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "It’s an orchestration, and there’s an art to it. When it comes to TransMedics...and we’re going to need the team...and they’re dragging their feet. And here we are scrambling to try to get to that timeline of can we get the team? Not just the procuring team who work for us but also the air charter and making sure the pilots don’t time out if we do a round trip, making sure that we have all the logistics set up for getting the team and if we have to use the device or not or a different technology or not or instead of equipment, the donor could be in way north Maine or they could be in an urban setting. We have to factor all of those things in. And so, here we are scrambling to get the orchestration done, but we ended up finding out TransMedics has been “working on certain things” for hours, and then we get notified, and so the only last-ditch effort before we forego the organ and potentially the organ will not be used because it might be up in eastern Maine, as I mentioned, then there’s no other option other than eat the cost. — Veteran transplant administrator/executive at Massachusetts General Hospital", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:05+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a978-4c0308b72e3a", "parentComponentId": null }, { "bbox": { "h": 0.03, "w": 0.25, "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:10.593+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "439bde2c-9275-41cb-b583-917ece5888ba", "parentComponentId": null }, { "bbox": { "h": 0.15, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "title", "text": "Case study 1: Massachusetts General Hospital (cont’d). MGH’s experience exposes the TransMedics NOP as a charade to pressure centers into paying for bundled services and air transport at inflated prices, not as a logistics “hub” that makes organ procurement faster or cheaper.", "attrs": null, "canon": { "kind": { "name": "Title", "slug": "title", "status": "active", "canonId": "019de52c-f7dd-76d9-b848-b1f12bd85cf4", "version": 1, "description": "Slide title or headline." }, "tool": null, "subkind": { "name": "Headline", "slug": "headline", "status": "active", "canonId": "019de52c-fae1-7463-9a7c-d60668eced0d", "version": 1, "description": null }, "framework": null }, "subkind": "headline", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:10.593+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "7f5476e1-bff9-4b57-897c-a3c8adce6e2e", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [], "arcBeats": [], "loops": [], "locked": true }, { "page": 67, "type": "tension", "title": "The slide uses direct quotes from a transplant surgeon to support the claim of coercive business practices.", "function": "expose_contradiction", "rawType": "expose_contradiction", "block": null, "metadata": { "slideType": "expose_contradiction", "slideTypeCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-124c-75aa-984a-0a3d0d8fc8df", "version": 1, "description": null }, "function": "expose_contradiction", "functionCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-171f-776f-887c-73edaff4cf9c", "version": 1, "description": null }, "density": "dense", "densityScore": 61, "componentCount": 7, "textChars": 2366, "nDataPoints": 0, "notes": "The slide uses direct quotes from a transplant surgeon to support the claim of coercive business practices.", "elementsJson": [ "paragraph", "quote_block" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:12:11.553+00", "seconds": 4.149, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/67", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-67", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": { "h": 0.15, "w": 0.86, "x": 0.07, "y": 0.45 }, "kind": "callout", "text": "TransMedics recently took away control of the device and transport and “boxed everyone into a corner...to use their transportation services.”\n“When we started this off, it used to be we had our own device. We bought our own cartridges, and we could use them as we pleased. And then they took our machine away and said, “No, you can’t.” It’s the lack of control over the device and now the lack of control over travel. So, they’ve really boxed everyone into a corner to use their transportation services.” - Transplant surgeon at a high volume West Coast academic center", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": null, "subkind": { "name": "Primary callout", "slug": "primary", "status": "active", "canonId": "019de52c-fbd1-70eb-a9ce-8997f8674c1d", "version": 1, "description": null }, "framework": null }, "subkind": "primary", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:11.553+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "027fcc84-2418-4bde-911e-76c93a1e0fb8", "parentComponentId": null }, { "bbox": { "h": 0.15, "w": 0.86, "x": 0.07, "y": 0.62 }, "kind": "callout", "text": "TransMedics “find ways to increase your costs” if you refuse to use their air travel\n“While I think they’ve backed off from saying you can only use our transportation company; they make it so onerous to do your own travel. They find ways to increase your costs - they’re kind of like giving you no option but to sign with the company and use their transportation.” - Transplant surgeon at a high volume West Coast academic center", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": null, "subkind": { "name": "Primary callout", "slug": "primary", "status": "active", "canonId": "019de52c-fbd1-70eb-a9ce-8997f8674c1d", "version": 1, "description": null }, "framework": null }, "subkind": "primary", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:11.553+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "1d4075a1-19de-45e5-ba7a-18d5d7ad535f", "parentComponentId": null }, { "bbox": null, "kind": "callout", "text": "TransMedics \"find ways to increase your costs\" if you refuse to use their air travel", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:05+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a977-dccd3a3e3436", "parentComponentId": null }, { "bbox": { "h": 0.25, "w": 0.86, "x": 0.07, "y": 0.12 }, "kind": "paragraph", "text": "UCSD is one of TransMedics highest volume users and described coercion similar to but even more overt than at Massachusetts General. A transplant surgeon stated that “when we started this off...we had or own device and we could use them as we pleased...then they took our machine away and said ‘No, you can’t.’” UCSD stated that TransMedics forces them to use the NOP by escalating the cost if they use their own air transport versus the company’s jets – “they make it so onerous to do your own travel...they find ways to increase your costs...giving you no option but to...use their transportation”; “lack of control over the device and now the lack of control over travel...they’ve really boxed everyone into a corner to use their transportation...”", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:11.553+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "6f64c0d2-fd4b-4d02-a8b6-538dab7be0f4", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "\"When we started this off, it used to be we had our own device. We bought our own cartridges, and we could use them as we pleased. And then they took our machine away and said, 'No, you can't.' It's the lack of control over the device and now the lack of control over travel. So, they've really boxed everyone into a corner to use their transportation services.\" — Transplant surgeon at a high volume West Coast academic center", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:05+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a977-e365322fa6ff", "parentComponentId": null }, { "bbox": { "h": 0.02, "w": 0.25, "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:11.553+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "5396cb9a-0102-495d-a126-e446b3bfc7f8", "parentComponentId": null }, { "bbox": { "h": 0.04, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "title", "text": "Case study 2: University of California, San Diego.", "attrs": null, "canon": { "kind": { "name": "Title", "slug": "title", "status": "active", "canonId": "019de52c-f7dd-76d9-b848-b1f12bd85cf4", "version": 1, "description": "Slide title or headline." }, "tool": null, "subkind": { "name": "Headline", "slug": "headline", "status": "active", "canonId": "019de52c-fae1-7463-9a7c-d60668eced0d", "version": 1, "description": null }, "framework": null }, "subkind": "headline", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:11.553+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "daa59306-310d-4934-8cb0-12ee1d94a7b2", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [ { "matchId": "12b89533-9b10-46e7-935d-64d9fb61e5d7", "evidence": "The slide explicitly frames the company's business practices as coercive and manipulative, aiming to expose unethical behavior.", "framework": null, "confidence": 0.85, "extraction": { "at": "2026-05-02 20:12:11.553+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 67, "frameworkName": "fraud-exposure" } ], "arcBeats": [], "loops": [], "locked": true }, { "page": 68, "type": "tension", "title": "The slide uses a Q&A transcript format to build a narrative of extortion.", "function": "expose_contradiction", "rawType": "expose_contradiction", "block": null, "metadata": { "slideType": "expose_contradiction", "slideTypeCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-124c-75aa-984a-0a3d0d8fc8df", "version": 1, "description": null }, "function": "expose_contradiction", "functionCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-171f-776f-887c-73edaff4cf9c", "version": 1, "description": null }, "density": "dense", "densityScore": 68, "componentCount": 7, "textChars": 3641, "nDataPoints": 1, "notes": "The slide uses a Q&A transcript format to build a narrative of extortion.", "elementsJson": [ "paragraph", "quote_block" ], "confidence": 0.95, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 21:25:57.306+00", "seconds": 12.202, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/68", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-68", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": { "h": 0.03, "w": 0.55, "x": 0.07, "y": 0.51 }, "kind": "callout", "text": "Detailed example of what appears to be extortion if UCSD doesn't use TransMedics air transport", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": null, "subkind": { "name": "Primary callout", "slug": "primary", "status": "active", "canonId": "019de52c-fbd1-70eb-a9ce-8997f8674c1d", "version": 1, "description": null }, "framework": null }, "subkind": "primary", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:25:57.306+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "4362b0f7-274e-4b0f-a6b2-0ebd499d6412", "parentComponentId": null }, { "bbox": null, "kind": "callout", "text": "This forces UCSD to eat the $50,000 transport cost to Seattle if the donor doesn't expire and no organ is available – pure extortion to punish TransMedics if it doesn't use their jets", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:04+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a976-d43d8d0483fd", "parentComponentId": null }, { "bbox": { "h": 0.35, "w": 0.85, "x": 0.07, "y": 0.13 }, "kind": "paragraph", "text": "UCSD shared detailed examples to illustrate how TransMedics allegedly puts a gun to their head to run up the cost and allegedly coerce them to use its jets. Previously, if a DCD organ donor was available in Seattle, TransMedics would send a procurement team available locally at their Seattle hub. If the donor didn't expire, UCSD didn't incur the cost to fly from San Diego to Seattle. Now, the only option they allegedly offer is to fly a TransMedics device and technician *from San Diego to Seattle* even though they have both locally in Seattle. This forces UCSD to eat the $50,000 transport cost to Seattle if the donor doesn't expire and no organ is available – pure extortion to punish TransMedics if it doesn't use their jets: \"if I say I want to use the NOP to get that liver in Seattle, but I don't want to use their transportation company, the only option they give me is traveling from San Diego...that's a round-trip ticket that's...$50,000...rather than just using their team in Seattle to recover the liver and fly it down to me.\"", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:25:57.306+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "ce8ff622-1fd1-409b-bb3b-4a2fa07c69c4", "parentComponentId": null }, { "bbox": { "h": 0.38, "w": 0.85, "x": 0.07, "y": 0.55 }, "kind": "paragraph", "text": "A: \"I'll give you a real-world example. I'm in San Diego. They have hubs all over the country with specialists, machines, surgeons. If I wanted to get a liver from Seattle, where they have a hub, the only way they would do it because we haven't signed with their transportation company was to fly the specialist and the machine from [major California city] to Seattle to do the case, even though they already have people in Seattle. Now, it's a DCD case, so it may not expire, and I've got to pay the $50,000 just to get the team up there, which defeats a large part of the purpose of having hubs everywhere. If I can't use the hub, I have to travel there. If I use their company, they'll do the case from their hub rather than fly in from San Diego. So, it's a $50,000 price difference in travel for me.\"\nQ: \"Just so I understand - they have a team locally in Seattle, and there's a donor in Seattle. If you want to send your own team, they're saying you have to do what?\"\nA: \"It's not even sending our own team. If I say I want to use the NOP to get that liver in Seattle, but I don't want to use their transportation company, the only option they give me is traveling from San Diego. So, they'll send a separate team that has nothing to do with me, their team from San Diego, which is also a hub, all the way to Seattle. That's a round-trip ticket that's going to cost me $50,000 to get there, rather than just using their team in Seattle to recover the liver and fly it down to me.\"\nQ: \"So, if you said I want to use my own air travel, but they're like you have to use our team. They'll fly their team from [major California city] to Seattle and then back if you want to use your own air travel. But if you use theirs, they'll just send the team from Seattle?\"\nA: \"Right.\" -Transplant surgeon at a high volume West Coast academic center", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:25:57.306+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "d6f4660d-8e07-42b2-a334-92f9ed6706e4", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "if I say I want to use the NOP to get that liver in Seattle, but I don't want to use their transportation company, the only option they give me is traveling from San Diego...that's a round-trip ticket that's...$50,000...rather than just using their team in Seattle to recover the liver and fly it down to me. — Transplant surgeon at a high volume West Coast academic center", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:04+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a976-dab82be11889", "parentComponentId": null }, { "bbox": { "h": 0.02, "w": 0.3, "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:25:57.306+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "4d9ad632-051b-4855-9fb3-125310d871cb", "parentComponentId": null }, { "bbox": { "h": 0.05, "w": 0.85, "x": 0.07, "y": 0.07 }, "kind": "title", "text": "Case study 2: University of California, San Diego.", "attrs": null, "canon": { "kind": { "name": "Title", "slug": "title", "status": "active", "canonId": "019de52c-f7dd-76d9-b848-b1f12bd85cf4", "version": 1, "description": "Slide title or headline." }, "tool": null, "subkind": { "name": "Headline", "slug": "headline", "status": "active", "canonId": "019de52c-fae1-7463-9a7c-d60668eced0d", "version": 1, "description": null }, "framework": null }, "subkind": "headline", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:25:57.306+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "c86f5691-5a51-49c5-9e68-48e67a150506", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [], "arcBeats": [], "loops": [], "locked": true }, { "page": 69, "type": "tension", "title": "The slide uses Q&A format to build a narrative of unethical behavior and coercion.", "function": "name_villain", "rawType": "villain_critique", "block": null, "metadata": { "slideType": "villain_critique", "slideTypeCanon": { "name": "Villain critique", "slug": "villain_critique", "status": "active", "canonId": "019de52d-10bc-7136-bf20-09de59d17447", "version": 1, "description": null }, "function": "name_villain", "functionCanon": { "name": "Name villain", "slug": "name_villain", "status": "active", "canonId": "019de52d-1746-70d6-bc58-5eeaf5865526", "version": 1, "description": null }, "density": "balanced", "densityScore": 33, "componentCount": 6, "textChars": 693, "nDataPoints": 1, "notes": "The slide uses Q&A format to build a narrative of unethical behavior and coercion.", "elementsJson": [ "headline_text", "paragraph", "quote_block" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:12:10.437+00", "seconds": 2.449, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/69", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-69", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "It’s like racketeering; mafia-style; thug-style", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:03+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a975-bc247e989ac4", "parentComponentId": null }, { "bbox": { "h": 0.55, "w": 0.85, "x": 0.07, "y": 0.35 }, "kind": "list", "text": "Q&A transcript excerpts highlighting allegations of unnecessary costs, forced contracts, and predatory behavior.", "attrs": null, "canon": { "kind": { "name": "List", "slug": "list", "status": "active", "canonId": "019de52c-f94b-779b-a53b-fd4904a5f4d2", "version": 1, "description": "Bullet or numbered list." }, "tool": null, "subkind": { "name": "Bullet list", "slug": "bullet", "status": "active", "canonId": "019de52c-fc98-7169-a083-5cab805076ca", "version": 1, "description": null }, "framework": null }, "subkind": "bullet", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:10.437+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "efe256ba-1fc5-43f6-93af-bfb7056312a9", "parentComponentId": null }, { "bbox": { "h": 0.15, "w": 0.85, "x": 0.07, "y": 0.12 }, "kind": "paragraph", "text": "UCSD described the tactics as retaliation and as “something new because our contract negotiations with them have been slow” regarding use of the air transport service.", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:10.437+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "ca0d3a62-ba03-4abf-8c08-8b5aff346b71", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "“they will talk themselves in circles trying to explain their rationale”; “they’re making an offer I can’t refuse...it’s like racketeering...mafia-style...a thug-style way of getting things done.” — Transplant surgeon at a high volume West Coast academic center", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:03+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a975-c3939506d2ae", "parentComponentId": null }, { "bbox": { "h": 0.03, "w": 0.3, "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:10.437+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "b220d41e-390d-4702-bf86-5170497b7e3c", "parentComponentId": null }, { "bbox": { "h": 0.05, "w": 0.85, "x": 0.07, "y": 0.07 }, "kind": "title", "text": "Case study 2: University of California, San Diego.", "attrs": null, "canon": { "kind": { "name": "Title", "slug": "title", "status": "active", "canonId": "019de52c-f7dd-76d9-b848-b1f12bd85cf4", "version": 1, "description": "Slide title or headline." }, "tool": null, "subkind": { "name": "Headline", "slug": "headline", "status": "active", "canonId": "019de52c-fae1-7463-9a7c-d60668eced0d", "version": 1, "description": null }, "framework": null }, "subkind": "headline", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:10.437+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "d8cfd66c-05d9-4589-93d9-931d0209bdb4", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [ { "matchId": "cb8c2966-4193-4657-81f7-7ea26266c1c7", "evidence": "The slide explicitly frames the subject company as a 'villain' using quotes like 'mafia-style' and 'racketeering'.", "framework": null, "confidence": 0.9, "extraction": { "at": "2026-05-02 20:12:10.437+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 69, "frameworkName": "antagonist-introduction" } ], "arcBeats": [], "loops": [], "locked": true }, { "page": 70, "type": "setup", "function": "transition", "rawType": "section_divider", "block": null, "metadata": { "slideType": "section_divider", "slideTypeCanon": { "name": "Section divider", "slug": "section_divider", "status": "active", "canonId": "019de52d-066a-7402-9554-6ae504999041", "version": 1, "description": null }, "function": "transition", "functionCanon": { "name": "Transition", "slug": "transition", "status": "active", "canonId": "019de52d-1365-7149-92aa-66df859e75fd", "version": 1, "description": null }, "density": "sparse", "densityScore": 7, "componentCount": 2, "textChars": 292, "nDataPoints": 0, "notes": null, "elementsJson": [ "paragraph" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 21:25:47.259+00", "seconds": 2.087, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/70", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-70", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "Part 2. The NOP service is, in our opinion, a large-scale fraudulent billing racket, predicated on overcharging hospitals for unnecessary flights.", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:03+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a976-93f0359eaad2", "parentComponentId": null }, { "bbox": { "h": 0.125, "w": 0.815, "x": 0.073, "y": 0.069 }, "kind": "title", "text": "Part 2. The NOP service is, in our opinion, a large-scale fraudulent billing racket, predicated on overcharging hospitals for unnecessary flights.", "attrs": null, "canon": { "kind": { "name": "Title", "slug": "title", "status": "active", "canonId": "019de52c-f7dd-76d9-b848-b1f12bd85cf4", "version": 1, "description": "Slide title or headline." }, "tool": null, "subkind": { "name": "Headline", "slug": "headline", "status": "active", "canonId": "019de52c-fae1-7463-9a7c-d60668eced0d", "version": 1, "description": null }, "framework": null }, "subkind": "headline", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:25:47.259+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "f44323bf-6a53-4a62-ba23-ecc83874a982", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [], "arcBeats": [], "loops": [], "locked": true }, { "page": 71, "type": "tension", "title": "The slide uses a map to visualize the scale of the company's operations, which the author then characterizes as a 'fraudulent billing conspiracy'.", "function": "expose_contradiction", "rawType": "geographic_map", "block": null, "metadata": { "slideType": "geographic_map", "slideTypeCanon": { "name": "Geographic map", "slug": "geographic_map", "status": "active", "canonId": "019de52d-09de-7153-8845-584c1a9d0c83", "version": 1, "description": null }, "function": "expose_contradiction", "functionCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-171f-776f-887c-73edaff4cf9c", "version": 1, "description": null }, "density": "balanced", "densityScore": 39, "componentCount": 6, "textChars": 744, "nDataPoints": 17, "notes": "The slide uses a map to visualize the scale of the company's operations, which the author then characterizes as a 'fraudulent billing conspiracy'.", "elementsJson": [ "paragraph", "map" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 21:25:52.554+00", "seconds": 7.211, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/71", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-71", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "TransMedics National OCS Program (NOP) is, we believe, a large-scale fraudulent billing conspiracy whereby customers - transplant centers and organ procurement organizations (OPO's) - are overcharged for its air transport service.", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:03+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a976-2b8216f46e1f", "parentComponentId": null }, { "bbox": { "h": 0.35, "w": 0.6, "x": 0.15, "y": 0.53 }, "kind": "image", "text": "Map of the US with 17 hub locations marked with concentric circles.", "attrs": null, "canon": { "kind": { "name": "Image", "slug": "image", "status": "active", "canonId": "019de52c-f978-701f-a720-51d029d769e7", "version": 1, "description": "Photo, illustration, screenshot or icon." }, "tool": null, "subkind": { "name": "Map", "slug": "map", "status": "active", "canonId": "019de52c-fe4d-77bd-b0a4-d72d58b9e5a4", "version": 1, "description": null }, "framework": null }, "subkind": "map", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:25:52.554+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "17ba042b-a2f6-4081-8473-aee0cbae09a4", "parentComponentId": null }, { "bbox": { "h": 0.15, "w": 0.9, "x": 0.07, "y": 0.07 }, "kind": "paragraph", "text": "TransMedics National OCS Program (NOP) is, we believe, a large-scale fraudulent billing conspiracy whereby customers - transplant centers and organ procurement organizations (OPO's) - are overcharged for its air transport service.", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:25:52.554+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "45f48475-c7a8-47c9-b69d-02a96ade5f4c", "parentComponentId": null }, { "bbox": { "h": 0.02, "w": 0.5, "x": 0.07, "y": 0.44 }, "kind": "source-note", "text": "National OCS Program (NOP) hubs around the US – investor presentation, Oct 2024", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:25:52.554+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "a9afacd9-9bab-41ba-9dd5-01c2bfcd7dfa", "parentComponentId": null }, { "bbox": { "h": 0.02, "w": 0.5, "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: https://investors.transmedics.com/static-files/5ed8fa71-5a64-4043-b1d4-025252b36ea1", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:25:52.554+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "ac9c40c9-1970-4e3a-a316-8aceda73495e", "parentComponentId": null }, { "bbox": { "h": 0.03, "w": 0.65, "x": 0.07, "y": 0.48 }, "kind": "title", "text": "NOP Hubs to Provide Broad Geographical Coverage", "attrs": null, "canon": { "kind": { "name": "Title", "slug": "title", "status": "active", "canonId": "019de52c-f7dd-76d9-b848-b1f12bd85cf4", "version": 1, "description": "Slide title or headline." }, "tool": null, "subkind": { "name": "Headline", "slug": "headline", "status": "active", "canonId": "019de52c-fae1-7463-9a7c-d60668eced0d", "version": 1, "description": null }, "framework": null }, "subkind": "headline", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:25:52.554+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "3351e948-a974-48a9-91e1-291586090ec0", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [ { "matchId": "ff5a9c84-ec49-4475-81fe-91d48abb580e", "evidence": "The slide explicitly labels the company's program as a 'fraudulent billing conspiracy' and uses the map to illustrate the scope of the alleged scheme.", "framework": null, "confidence": 0.95, "extraction": { "at": "2026-05-02 21:25:52.554+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 71, "frameworkName": "fraud-exposure" } ], "arcBeats": [], "loops": [], "locked": true }, { "page": 72, "type": "tension", "title": "The slide uses a Q&A format to validate the claims of systematic fraud.", "function": "expose_contradiction", "rawType": "expose_contradiction", "block": null, "metadata": { "slideType": "expose_contradiction", "slideTypeCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-124c-75aa-984a-0a3d0d8fc8df", "version": 1, "description": null }, "function": "expose_contradiction", "functionCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-171f-776f-887c-73edaff4cf9c", "version": 1, "description": null }, "density": "balanced", "densityScore": 44, "componentCount": 6, "textChars": 1157, "nDataPoints": 1, "notes": "The slide uses a Q&A format to validate the claims of systematic fraud.", "elementsJson": [ "paragraph", "quote_block" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:12:11.064+00", "seconds": 2.988, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/72", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-72", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "Ex-employees and hospitals described two key mechanisms of systematic billing fraud: 1) flying in non-local procurement teams by jet when a local team is already available at its hub and could be driven, indicating the sole purpose was to exploit the customer via unnecessary air transport charges; 2) sending staff on multiple jets to the same location to further inflate the charge.", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:03+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a976-14fe81d585e8", "parentComponentId": null }, { "bbox": { "h": 0.45, "w": 0.86, "x": 0.07, "y": 0.19 }, "kind": "paragraph", "text": "1) flying in non-local procurement teams by jet when a local team is already available at its hub and could be driven... 2) sending staff on multiple jets to the same location to further inflate the charge.", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:11.064+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "750a5663-e0a6-49cc-bdaf-18e327893a45", "parentComponentId": null }, { "bbox": { "h": 0.25, "w": 0.86, "x": 0.07, "y": 0.65 }, "kind": "paragraph", "text": "Flying in nonlocal teams versus driving the local team... Over half of procurements were within driving distance; specialist would typically fly “independently”", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:11.064+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "9b4fa8c9-f557-4d53-8cd2-fc4539fef3ce", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "“just entirely unethical,” beginning when the NOP was established: “it’s a big reason why I decided to get out of the company”; “since they purchased aircraft, they were flying in nonlocal teams versus driving the local team.” — Former OCS Specialist who left recently", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:03+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a976-1b9d62caa53a", "parentComponentId": null }, { "bbox": { "h": 0.03, "w": 0.3, "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:11.064+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "9c13bc07-e888-4b16-b2e5-e1cb1b2573d2", "parentComponentId": null }, { "bbox": { "h": 0.12, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "title", "text": "Ex-employees and hospitals described two key mechanisms of systematic billing fraud", "attrs": null, "canon": { "kind": { "name": "Title", "slug": "title", "status": "active", "canonId": "019de52c-f7dd-76d9-b848-b1f12bd85cf4", "version": 1, "description": "Slide title or headline." }, "tool": null, "subkind": { "name": "Headline", "slug": "headline", "status": "active", "canonId": "019de52c-fae1-7463-9a7c-d60668eced0d", "version": 1, "description": null }, "framework": null }, "subkind": "headline", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:11.064+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "ee433f90-ccf9-49c6-8208-cfb5c8b8bfec", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [ { "matchId": "c556ef33-6dc6-40fe-be86-f9f3b331409a", "evidence": "The slide explicitly details mechanisms of systematic billing fraud.", "framework": null, "confidence": 1, "extraction": { "at": "2026-05-02 20:12:11.064+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 72, "frameworkName": "fraud-exposure" } ], "arcBeats": [], "loops": [], "locked": true }, { "page": 73, "type": "tension", "title": "The slide uses a Q&A format to present testimony regarding unethical business practices and overbilling.", "function": "expose_contradiction", "rawType": "expose_contradiction", "block": null, "metadata": { "slideType": "expose_contradiction", "slideTypeCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-124c-75aa-984a-0a3d0d8fc8df", "version": 1, "description": null }, "function": "expose_contradiction", "functionCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-171f-776f-887c-73edaff4cf9c", "version": 1, "description": null }, "density": "balanced", "densityScore": 41, "componentCount": 6, "textChars": 1185, "nDataPoints": 0, "notes": "The slide uses a Q&A format to present testimony regarding unethical business practices and overbilling.", "elementsJson": [ "paragraph", "quote_block", "footnote" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:12:14.021+00", "seconds": 5.898, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/73", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-73", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "I think that they are utilizing their aircraft to bill for the aircraft.", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:05+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a978-03b18312d4ab", "parentComponentId": null }, { "bbox": { "h": 0.25, "w": 0.86, "x": 0.07, "y": 0.69 }, "kind": "list", "text": "Flying in nonlocal teams from places like Texas when it “makes zero sense”", "attrs": null, "canon": { "kind": { "name": "List", "slug": "list", "status": "active", "canonId": "019de52c-f94b-779b-a53b-fd4904a5f4d2", "version": 1, "description": "Bullet or numbered list." }, "tool": null, "subkind": { "name": "Bullet list", "slug": "bullet", "status": "active", "canonId": "019de52c-fc98-7169-a083-5cab805076ca", "version": 1, "description": null }, "framework": null }, "subkind": "bullet", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:14.021+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "a0cec4bb-31ad-44c2-a6ea-df327e5bf4e5", "parentComponentId": null }, { "bbox": { "h": 0.35, "w": 0.86, "x": 0.07, "y": 0.33 }, "kind": "list", "text": "Flying in teams via jets just to bill for the aircraft, when local teams are available", "attrs": null, "canon": { "kind": { "name": "List", "slug": "list", "status": "active", "canonId": "019de52c-f94b-779b-a53b-fd4904a5f4d2", "version": 1, "description": "Bullet or numbered list." }, "tool": null, "subkind": { "name": "Bullet list", "slug": "bullet", "status": "active", "canonId": "019de52c-fc98-7169-a083-5cab805076ca", "version": 1, "description": null }, "framework": null }, "subkind": "bullet", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:14.021+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "ace729fd-bdf8-46e0-9244-6aa4a6bff34b", "parentComponentId": null }, { "bbox": { "h": 0.25, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "paragraph", "text": "The OCS Specialist provided numerous examples of TransMedics flying in nonlocal procurement teams to Seattle when teams were already present at the local hub and with nothing to do. The specialist stated the company was secretive and that Seattle staff were not “given a reason” – “why are you flying a team from Texas or California when we have a full team of 10 people up here waiting to do cases?”; “it’s cheaper to send a local team…they are utilizing their aircraft to bill for the aircraft.” TransMedics flew in planes even when both the donor and recipient were within driving distance, describing specific incidents such as when planes were flown in from Texas “which makes zero sense…even one of the cardiac surgeons was like, why are you sending this team when we’re here?”", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:14.021+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "bac0c375-008b-407c-a698-372185b3f094", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "I think that they are utilizing their aircraft to bill for the aircraft. — Former OCS Specialist who left recently", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:05+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a978-0429a34f5c04", "parentComponentId": null }, { "bbox": { "h": 0.03, "w": 0.3, "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:14.021+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "388d575a-4109-455f-91c1-d276a2be0504", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [ { "matchId": "1a6fb0d7-8156-4b89-a3fe-ac950bc1611f", "evidence": "The slide presents testimony alleging unethical overbilling practices.", "framework": null, "confidence": 0.9, "extraction": { "at": "2026-05-02 20:12:14.021+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 73, "frameworkName": "fraud-exposure" } ], "arcBeats": [], "loops": [], "locked": true }, { "page": 74, "type": "tension", "title": "The slide uses a Q&A format to build a case for fraudulent billing practices.", "function": "expose_contradiction", "rawType": "expose_contradiction", "block": null, "metadata": { "slideType": "expose_contradiction", "slideTypeCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-124c-75aa-984a-0a3d0d8fc8df", "version": 1, "description": null }, "function": "expose_contradiction", "functionCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-171f-776f-887c-73edaff4cf9c", "version": 1, "description": null }, "density": "dense", "densityScore": 55, "componentCount": 6, "textChars": 3082, "nDataPoints": 0, "notes": "The slide uses a Q&A format to build a case for fraudulent billing practices.", "elementsJson": [ "paragraph", "quote_block", "footnote" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:12:12.131+00", "seconds": 3.431, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/74", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-74", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "The OCS Specialist indicated the practice of flying in nonlocal teams is now the norm, not an outlier, suggesting fraudulent air billing on a vast scale; and that it began only after TransMedics purchased its own jets, providing further evidence that the real purpose of the NOP’s air transport operation is to inflate charges to transplant centers, not to drive efficiency.", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:04+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a977-4c9d73d8b59c", "parentComponentId": null }, { "bbox": { "h": 0.05, "w": 0.86, "x": 0.07, "y": 0.35 }, "kind": "paragraph", "text": "Regularly flying in nonlocal teams; allegedly began after TransMedics purchased the aircraft", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:12.131+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "48e1d4f2-87cb-475a-b81a-64f06d42381f", "parentComponentId": null }, { "bbox": { "h": 0.45, "w": 0.86, "x": 0.07, "y": 0.42 }, "kind": "quote", "text": "Q: \"Obviously, it's cheaper to send the local team. What percentage of local cases would they fly in somebody for?\"\nA: \"It was variable, but I would say the last couple of months prior to me leaving, it was pretty consistent. If the organ was going outside, like let's say it was Seattle to California, Seattle to San Diego, they would fly up a San Diego team or a San Ramon team even if the case was a brain death donation...It used to be how they that if it was a brain death donor, they would fly in the team closest to the recipient center because they were quite certain that the organ was viable and it would be atypical for that organ to be turned down once the team showed up. They would fly the team from closest to the recipient center because they would have to go back there anyway. If it was a DCD, where the donor has to to still expire within a certain amount of time for the organ to be viable, they would send the local team because if the donor didn't expire, then you haven't invested a significant amount of money to get people from out of state here. So you only have the front-end cost to just be basically the transport from the local hub. That's how it used to be. But since they purchased their planes, they basically were like, we're not going by this model anymore.\"\nQ: \"This business of flying in people from elsewhere started after they got the planes. They were trying to use the planes?\"\nA: \"Yes, that's what it seemed to match up with. That seems to be when it started happening.\"\nQ: \"And before that, obviously, they would not have sent a charter service from across the country; it could have been done locally. They only did that once they had planes they could bill?\"\nA: \"Unless there just wasn't a local team available because they were on cases.\" - Former OCS Specialist who left recently", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:12.131+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "46bd6983-8850-4bc8-97a8-aee7cd739dae", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "“the last couple of months prior to me leaving, it was pretty consistent...since they purchased the planes, they basically were like, we’re not going to do this model anymore [of using the closest team to the donor]”; “it seemed to match up with” when TransMedics first bought the aircraft; “that seems to be when it started happening.” — Former OCS Specialist", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:04+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a977-51870943fd40", "parentComponentId": null }, { "bbox": { "h": 0.03, "w": 0.3, "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:12.131+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "9325de3f-40a2-4c72-a053-cbf521e29a57", "parentComponentId": null }, { "bbox": { "h": 0.25, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "title", "text": "The OCS Specialist indicated the practice of flying in nonlocal teams is now the norm, not an outlier, suggesting fraudulent air billing on a vast scale; and that it began only after TransMedics purchased its own jets, providing further evidence that the real purpose of the NOP’s air transport operation is to inflate charges to transplant centers, not to drive efficiency.", "attrs": null, "canon": { "kind": { "name": "Title", "slug": "title", "status": "active", "canonId": "019de52c-f7dd-76d9-b848-b1f12bd85cf4", "version": 1, "description": "Slide title or headline." }, "tool": null, "subkind": { "name": "Headline", "slug": "headline", "status": "active", "canonId": "019de52c-fae1-7463-9a7c-d60668eced0d", "version": 1, "description": null }, "framework": null }, "subkind": "headline", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:12.131+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "ed9a12e1-91e3-4af5-98e2-24529b3905cc", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [ { "matchId": "f1db08c5-527f-4744-8a6b-8ab7feb4a92c", "evidence": "The slide explicitly frames the testimony as evidence of fraudulent air billing.", "framework": null, "confidence": 0.9, "extraction": { "at": "2026-05-02 20:12:12.131+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 74, "frameworkName": "fraud-exposure" } ], "arcBeats": [], "loops": [], "locked": true }, { "page": 75, "type": "tension", "title": "The slide uses Q&A transcripts to expose a contradiction between operational efficiency and the company's new logistics model.", "function": "expose_contradiction", "rawType": "expose_contradiction", "block": null, "metadata": { "slideType": "expose_contradiction", "slideTypeCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-124c-75aa-984a-0a3d0d8fc8df", "version": 1, "description": null }, "function": "expose_contradiction", "functionCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-171f-776f-887c-73edaff4cf9c", "version": 1, "description": null }, "density": "overcrowded", "densityScore": 77, "componentCount": 8, "textChars": 3472, "nDataPoints": 4, "notes": "The slide uses Q&A transcripts to expose a contradiction between operational efficiency and the company's new logistics model.", "elementsJson": [ "paragraph", "quote_block" ], "confidence": 0.95, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:12:12.516+00", "seconds": 3.725, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/75", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-75", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "As further evidence of the scale and regularity of inflated air transport charges, the OCS Specialist indicated that teams at the Seattle hub were now rarely utilized in favor of flying in nonlocal teams instead", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:03+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a976-3df05fea0daa", "parentComponentId": null }, { "bbox": { "h": 0.02, "w": 0.5, "x": 0.07, "y": 0.44 }, "kind": "list", "text": "Specialists sat idle for months when TransMedics started flying in planes instead", "attrs": null, "canon": { "kind": { "name": "List", "slug": "list", "status": "active", "canonId": "019de52c-f94b-779b-a53b-fd4904a5f4d2", "version": 1, "description": "Bullet or numbered list." }, "tool": null, "subkind": { "name": "Bullet list", "slug": "bullet", "status": "active", "canonId": "019de52c-fc98-7169-a083-5cab805076ca", "version": 1, "description": null }, "framework": null }, "subkind": "bullet", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:12.516+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "1105f392-2e58-4b93-810c-44ff160edce5", "parentComponentId": null }, { "bbox": { "h": 0.02, "w": 0.5, "x": 0.07, "y": 0.75 }, "kind": "list", "text": "9 to 11 OCS Specialists in Seattle rarely utilized after TransMedics bought planes", "attrs": null, "canon": { "kind": { "name": "List", "slug": "list", "status": "active", "canonId": "019de52c-f94b-779b-a53b-fd4904a5f4d2", "version": 1, "description": "Bullet or numbered list." }, "tool": null, "subkind": { "name": "Bullet list", "slug": "bullet", "status": "active", "canonId": "019de52c-fc98-7169-a083-5cab805076ca", "version": 1, "description": null }, "framework": null }, "subkind": "bullet", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:12.516+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "5f34b43c-61e1-480a-a821-881f0010388f", "parentComponentId": null }, { "bbox": { "h": 0.15, "w": 0.86, "x": 0.07, "y": 0.78 }, "kind": "paragraph", "text": "Q: “How many people did they have in Seattle? What was the composition of the team?”\nA: “I want to say between 9 and 11. All OCS specialists.”\nQ: “Were they all sitting around, or were some of them being utilized and you weren’t being utilized?”\nA: “Yeah, when I left, it was kind of similar...it wasn’t unusual for them to go a month or more without doing a case.”\nQ: “Was it always those kinds of gaps or did those gaps start after they got the planes?”\nA: “I would say more so after they got the planes.” – Former OCS Specialist who left recently", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:12.516+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "1bd98689-b87a-49b4-b7f5-c91515d8d97e", "parentComponentId": null }, { "bbox": { "h": 0.25, "w": 0.86, "x": 0.07, "y": 0.47 }, "kind": "paragraph", "text": "Q: “How many cases were you doing every month or every quarter? How many organs were you procuring?”\nA: “It’s interesting because I was pretty busy. When I was in [redacted], I was doing almost a case a day to the point where I was like this is overwhelming. Like any day I was on call, I was getting called on a case. But out of seven days on call, I was probably doing three to four cases or two to four cases a week. Before I left, I hadn’t done a case in almost two months because cases that were scheduled for Seattle were being assigned elsewhere.”\nQ: “Do you know what they charged for a local team versus using a plane?”\nA: “They would use a third-party service to get us from our local hub to the hospitals, and if it was within a three-hour radius, I assume it was billed based on time or mileage. As far as transportation goes, that’s it. It would just be a few grand, I’m assuming, versus upwards of - depending on where you’re going - $30,000 to $100,000.” – Former OCS Specialist who left recently", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:12.516+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "d64b8727-9790-422a-93ea-c5f464d490a8", "parentComponentId": null }, { "bbox": { "h": 0.35, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "paragraph", "text": "As further evidence of the scale and regularity of inflated air transport charges, the OCS Specialist indicated that teams at the Seattle hub were now rarely utilized in favor of flying in nonlocal teams instead – and indicated the transport charge was likely $30,000 to $100,000 versus “just a few grand” if driving a local team. Prior to the aircraft being purchased, the ex-employee “was doing almost a case a day to the point...this is overwhelming” but “before I left, I hadn’t done a case in almost two month because cases that were scheduled for Seattle were being assigned elsewhere.” The Seattle had between 9 to 11 OCS Specialists to operate the device, per the ex-employee, but they just sat idle after TransMedics began flying in teams: “it wasn’t unusual for them to go a month or more without doing a case...I would say more so after they got the planes.”", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:12.516+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "e2fd00e3-5f8b-4776-9f01-fe1f92bf637c", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "It's interesting because I was pretty busy. When I was in [redacted], I was doing almost a case a day to the point where I was like this is overwhelming. Like any day I was on call, I was getting called on a case. But out of seven days on call, I was probably doing three to four cases or two to four cases a week. Before I left, I hadn't done a case in almost two months because cases that were scheduled for Seattle were being assigned elsewhere. ... it wasn't unusual for them to go a month or more without doing a case...I would say more so after they got the planes. — Former OCS Specialist who left recently", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:03+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a976-436aa0441af6", "parentComponentId": null }, { "bbox": { "h": 0.02, "w": 0.25, "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:12.516+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "417a49ed-76ea-4331-8819-e700cc3fa1d2", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [], "arcBeats": [], "loops": [], "locked": true }, { "page": 76, "type": "tension", "title": "The slide uses a Q&A format to highlight internal confusion and the visibility of national operations via an internal app.", "function": "expose_contradiction", "rawType": "testimonial", "block": null, "metadata": { "slideType": "testimonial", "slideTypeCanon": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52d-0a2d-7782-8a48-7e84df92cc97", "version": 1, "description": null }, "function": "expose_contradiction", "functionCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-171f-776f-887c-73edaff4cf9c", "version": 1, "description": null }, "density": "dense", "densityScore": 52, "componentCount": 5, "textChars": 2798, "nDataPoints": 1, "notes": "The slide uses a Q&A format to highlight internal confusion and the visibility of national operations via an internal app.", "elementsJson": [ "paragraph", "quote_block", "footnote" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:12:14.788+00", "seconds": 5.989, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/76", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-76", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "The OCS Specialist stated that the practice occurred nationally, not just at the Seattle hub, and was cloaked in secrecy, given \"upwards of 100 OCS Specialists across the country\" who could observe questionable aircraft movements on an internal phone app for case assignment and who \"probably have the same questions\" – \"it just doesn't make any sense...we've just not been told...I could see on our app planes being assigned but not understanding why...I could see the whole country.\"", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:07+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a97a-1071318cdb2b", "parentComponentId": null }, { "bbox": { "h": 0.25, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "paragraph", "text": "The OCS Specialist stated that the practice occurred nationally, not just at the Seattle hub, and was cloaked in secrecy, given “upwards of 100 OCS Specialists across the country” who could observe questionable aircraft movements on an internal phone app for case assignment and who “probably have the same questions” – “it just doesn’t make any sense…we’ve just not been told…I could see on our app planes being assigned but not understanding why…I could see the whole country.”", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:14.788+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "2d8943d1-9d24-40c1-8128-351dd13a3228", "parentComponentId": null }, { "bbox": { "h": 0.5, "w": 0.86, "x": 0.07, "y": 0.35 }, "kind": "quote", "text": "OCS specialists at hubs around the entire country could see questionable usage of aircraft\nA: “I want to say there were upwards of 100 OCS Specialists across the country. We all had company phones, so we would keep in touch using company or personal phones.”\nQ: “What would the other OCS specialists say? Did they confirm some of this stuff, like why are they flying in teams when we have local staff?”\nA: “I would say that they probably have the same questions. We just don’t know, and it just doesn’t make sense, and we’ve just not really been told…I could see on our app planes being assigned to what, but not understanding why. It was an internal app for case assignment. I could see the whole country, anyone who’s on call or not on call; you could go into the app and see who’s being assigned for what…I could see exactly what specialist is being assigned to a particular case. If it’s not a local person that’s being assigned to a local case, it makes me wonder why.” - Former OCS Specialist who left recently", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:14.788+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "24973e8d-bfea-446f-907f-8818b4340333", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "“I want to say there were upwards of 100 OCS Specialists across the country. We all had company phones, so we would keep in touch using company or personal phones.” ... “I would say that they probably have the same questions. We just don't know, and it just doesn't make any sense, and we've just not been told...I could see on our app planes being assigned to what, but not understanding why. It was an internal app for case assignment. I could see the whole country, anyone who's on call or not on call; you could go into the app and see who's being assigned for what...I could see exactly what specialist is being assigned to a particular case. If it's not a local person that's being assigned to a local case, it makes me wonder why.” — Former OCS Specialist", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:07+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a97a-15db5df812c7", "parentComponentId": null }, { "bbox": { "h": 0.03, "w": 0.3, "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:14.788+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "624c4dfe-cd9a-463c-806e-bb75f0b64b59", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [], "arcBeats": [], "loops": [], "locked": true }, { "page": 77, "type": "tension", "title": "The slide uses a Q&A format to highlight specific allegations of corporate misconduct.", "function": "expose_contradiction", "rawType": "expose_contradiction", "block": null, "metadata": { "slideType": "expose_contradiction", "slideTypeCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-124c-75aa-984a-0a3d0d8fc8df", "version": 1, "description": null }, "function": "expose_contradiction", "functionCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-171f-776f-887c-73edaff4cf9c", "version": 1, "description": null }, "density": "dense", "densityScore": 53, "componentCount": 6, "textChars": 2572, "nDataPoints": 0, "notes": "The slide uses a Q&A format to highlight specific allegations of corporate misconduct.", "elementsJson": [ "paragraph", "quote_block", "footnote" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:12:11.973+00", "seconds": 3.143, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/77", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-77", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "The OCS Specialist resigned because the company was “entirely unethical,” and described a “weird secretive culture” with CEO conduct suggestive of a racket and cover-up.", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:04+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a977-65650a1f041c", "parentComponentId": null }, { "bbox": { "h": 0.35, "w": 0.86, "x": 0.07, "y": 0.48 }, "kind": "paragraph", "text": "Q: “You said part of the reason why you left is you didn’t think it was an ethical company. Walk me through the different things that make you think that.”\nA: “The biggest one that stands out to me is just this weird way that they are utilizing their staff without an explanation and a complete lack of transparency as to what is happening on many levels. One of my close colleagues was told by one of the TransMedics pilots that he was told by Waleed to not talk to the specialists...they are intentionally keeping people in these dark silos so that they don’t have a grasp of what’s going on.”\nQ: “What were your colleagues’ theories?”\nA: “It’s just like this weird lack of transparency, this weird secretive culture, and it just felt like everyone is intentionally kept in the dark so that any sort of information couldn’t be used against the company in any way. And Waleed was always like, if anyone has questions, refer them back to us...the pilots were like, “We were told not to talk to you guys.” - Former OCS Specialist who left recently", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:11.973+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "060e9aa9-9945-4051-a7e2-8684616524f1", "parentComponentId": null }, { "bbox": { "h": 0.35, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "paragraph", "text": "The OCS Specialist resigned because the company was “entirely unethical,” and described a “weird secretive culture” with CEO conduct suggestive of a racket and cover-up, when we asked what specifically was unethical - “weird way that they are utilizing their staff without an explanation and a complete lack of transparency”; “one of the TransMedics pilots...was told by Waleed to not talk to the specialists...they are intentionally keeping people in these dark silos so that they don’t have a grasp of what’s going on”; “everyone is intentionally kept in the dark so that any sort of information couldn’t be used against the company in any way...Waleed was always like, if anyone has questions, refer them back to us....the pilots were like, ‘we were told not to talk to you guys.’”", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:11.973+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "6087470e-a83c-4c3d-b967-d840b1e141d0", "parentComponentId": null }, { "bbox": { "h": 0.03, "w": 0.45, "x": 0.07, "y": 0.45 }, "kind": "paragraph", "text": "Secrecy and lack of transparency around usage of aircraft", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:11.973+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "dbcf6969-591b-4625-b4fb-7b959cdb06be", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "“The biggest one that stands out to me is just this weird way that they are utilizing their staff without an explanation and a complete lack of transparency as to what is happening on many levels. One of my close colleagues was told by one of the TransMedics pilots that he was told by Waleed to not talk to the specialists...they are intentionally keeping people in these dark silos so that they don't have a grasp of what's going on.” — Former OCS Specialist", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:04+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a977-68fb8c80cb0a", "parentComponentId": null }, { "bbox": { "h": 0.02, "w": 0.25, "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:11.973+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "57a08c9b-0c75-46fd-bd6e-ba552d411228", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [], "arcBeats": [], "loops": [], "locked": true }, { "page": 78, "type": "tension", "title": "The slide uses highlighted text blocks to emphasize key quotes from a consultation call transcript.", "function": "expose_contradiction", "rawType": "expose_contradiction", "block": null, "metadata": { "slideType": "expose_contradiction", "slideTypeCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-124c-75aa-984a-0a3d0d8fc8df", "version": 1, "description": null }, "function": "expose_contradiction", "functionCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-171f-776f-887c-73edaff4cf9c", "version": 1, "description": null }, "density": "dense", "densityScore": 51, "componentCount": 5, "textChars": 3665, "nDataPoints": 0, "notes": "The slide uses highlighted text blocks to emphasize key quotes from a consultation call transcript.", "elementsJson": [ "paragraph", "quote_block", "footnote" ], "confidence": 0.9, "extraction": { "model": "google/gemini-3.5-flash", "runId": null, "at": "2026-07-17 03:49:53.973+00", "seconds": 8.651, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/78", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-78", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "everything at this company feels like a big secret, and it’s really weird and sketchy.", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:03+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a976-53d6b1209a01", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "Flying in teams when local staff at the hub could drive to hospital instead\nQ: “I heard is they have this local team in Seattle, and they’re just flying in teams from other parts of the country. I heard sometimes they’re even flying in two planes with people from different parts of the country. They’re not telling the team why they aren’t using them. The suspicion is they want to bill the flight to make more money.”\nA: “[Laughs] You’re not the only one with that suspicion.”\nQ: “Walk me through what you observed there because two or three people have mentioned that to me.”\nA: “It was all very - everything at this company feels like a big secret, and it’s really weird and sketchy. There would be times when we would have multiple people on call in Seattle. They would have a specialist available. And then you would probably have a surgeon available, too. And then all of a sudden - and it would be at some different part of Washington, like Spokane, which is like a four-hour drive So, instead of sending me from Seattle and a Seattle surgeon, they would fly someone in from Southern California and have them do the case in a hospital in Seattle or somewhere else, And no one could ever make sense of why they were doing the things they were doing. All of a sudden, these other cases are happening, and nobody knows how they’re figuring out who’s doing these cases or where they’re coming from, and you have people sitting in Seattle doing nothing and saying, why am I not doing this case? And they’d be like, oh, that’s logistics; don’t worry about it.” - Former TransMedics OCS specialist", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-07-17 03:49:53.973+00", "model": "google/gemini-3.5-flash", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "eb14271a-cc8c-4447-b6ab-5a4d56ad641e", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "“It was all very - everything at this company feels like a big secret, and it’s really weird and sketchy. There would be times when we would have multiple people on call in Seattle. They would have a specialist available. And then you would probably have a surgeon available, too. And then all of a sudden - and it would be at some different part of Washington, like Spokane, which is like a four-hour drive So, instead of sending me from Seattle and a Seattle surgeon, they would fly someone in from Southern California and have them do the case in a hospital in Seattle or somewhere else, And no one could ever make sense of why they were doing the things they were doing. All of a sudden, these other cases are happening, and nobody knows how they’re figuring out who’s doing these cases or where they’re coming from, and you have people sitting in Seattle doing nothing and saying, why am I not doing this case? And they’d be like, oh, that’s logistics; don’t worry about it.” — Former TransMedics OCS specialist", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:03+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a976-557eda4fd6f6", "parentComponentId": null }, { "bbox": null, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": "annotation", "groupRole": null, "confidence": null, "extraction": { "at": "2026-07-17 03:49:53.973+00", "model": "google/gemini-3.5-flash", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "27eceff4-a616-4e87-b4c2-2e69b5f36014", "parentComponentId": null }, { "bbox": null, "kind": "title", "text": "A second OCS Specialist confirmed the air transport billing scheme and provided additional evidence suggesting active, ongoing attempts to manipulate the company's internal systems as a cover-up: \"everything at this company feels like a big secret, and it's really weird and sketchy.\" The ex-employee described shock among staff stationed at hubs when they would see TransMedics fly in teams from around the country, when the local team already at the hub could have simply driven to retrieve the organ – “we have multiple people on call in Seattle...and then all of a sudden...they would fly someone in from Southern California and have them do the case in a hospital in Seattle...no one could ever make sense of why they were doing the things they were doing...people sitting in Seattle doing nothing and saying, why am I not doing this case? And they’d be like, oh, that’s logistics, don’t worry about it.”", "attrs": null, "canon": { "kind": { "name": "Title", "slug": "title", "status": "active", "canonId": "019de52c-f7dd-76d9-b848-b1f12bd85cf4", "version": 1, "description": "Slide title or headline." }, "tool": null, "subkind": { "name": "Action title", "slug": "action-title", "status": "active", "canonId": "019de52c-fb31-734c-a0f5-a3935b73135d", "version": 1, "description": null }, "framework": null }, "subkind": "action-title", "groupRole": null, "confidence": null, "extraction": { "at": "2026-07-17 03:49:53.973+00", "model": "google/gemini-3.5-flash", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "cc62bf59-4f87-4d40-ad9f-84460919500b", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [], "arcBeats": [], "loops": [], "locked": true }, { "page": 79, "type": "tension", "title": "The slide uses a Q&A format to build credibility and expose operational inefficiencies.", "function": "expose_contradiction", "rawType": "expose_contradiction", "block": null, "metadata": { "slideType": "expose_contradiction", "slideTypeCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-124c-75aa-984a-0a3d0d8fc8df", "version": 1, "description": null }, "function": "expose_contradiction", "functionCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-171f-776f-887c-73edaff4cf9c", "version": 1, "description": null }, "density": "dense", "densityScore": 61, "componentCount": 8, "textChars": 1437, "nDataPoints": 0, "notes": "The slide uses a Q&A format to build credibility and expose operational inefficiencies.", "elementsJson": [ "paragraph", "quote_block" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:12:12.693+00", "seconds": 2.978, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/79", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-79", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": { "h": 0.05, "w": 0.86, "x": 0.07, "y": 0.38 }, "kind": "callout", "text": "Flying in nonlocal teams “frequently” from other states, even when the donor and recipient are both in the same state and the entire process could be handled entirely by the local team", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": null, "subkind": { "name": "Primary callout", "slug": "primary", "status": "active", "canonId": "019de52c-fbd1-70eb-a9ce-8997f8674c1d", "version": 1, "description": null }, "framework": null }, "subkind": "primary", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:12.693+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "557eba2c-9328-4c91-808e-ab77f5fba39f", "parentComponentId": null }, { "bbox": null, "kind": "callout", "text": "Flying in nonlocal teams \"frequently\" from other states, even when the donor and recipient are both in the same state and the entire process could be handled entirely by the local team", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:02+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a975-ab7b5ce5abe5", "parentComponentId": null }, { "bbox": { "h": 0.25, "w": 0.86, "x": 0.07, "y": 0.44 }, "kind": "list", "text": "Q&A transcript excerpts detailing the frequency of complaints and the specific example of Washington-based cases.", "attrs": null, "canon": { "kind": { "name": "List", "slug": "list", "status": "active", "canonId": "019de52c-f94b-779b-a53b-fd4904a5f4d2", "version": 1, "description": "Bullet or numbered list." }, "tool": null, "subkind": { "name": "Bullet list", "slug": "bullet", "status": "active", "canonId": "019de52c-fc98-7169-a083-5cab805076ca", "version": 1, "description": null }, "framework": null }, "subkind": "bullet", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:12.693+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "000c847e-05be-490a-a1bc-42a90be84605", "parentComponentId": null }, { "bbox": { "h": 0.08, "w": 0.86, "x": 0.07, "y": 0.23 }, "kind": "paragraph", "text": "For the avoidance of doubt as to the level of egregiousness, we asked if the specialist witnessed cases where both the donor and recipient were in Washington and the local team could have simply driven with the device and surgeon, but where TransMedics still flew in a team from another state: “I believe so [laughs]...this is so ridiculous.”", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:12.693+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "2734e92c-a1ec-44b3-875c-565d1e15d385", "parentComponentId": null }, { "bbox": { "h": 0.08, "w": 0.86, "x": 0.07, "y": 0.15 }, "kind": "paragraph", "text": "“it was happening kind of frequently...I know other people complained about it a lot...it seemed really weird to be flying people in from somewhere else to do cases that were here in the state...nobody knows the answer to why.”", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:12.693+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "c68f120d-88a4-4eec-878d-531782d69372", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "\"It was happening kind of frequently...I know other people complained about it a lot...it seemed really weird to be flying people in from somewhere else to do cases that were here in the state...nobody knows the answer to why.\" — Former TransMedics OCS specialist", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:02+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a975-af9ced155c51", "parentComponentId": null }, { "bbox": { "h": 0.02, "w": 0.25, "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:12.693+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "f3b455f1-3438-45a5-9361-a146107e1968", "parentComponentId": null }, { "bbox": { "h": 0.08, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "title", "text": "The second OCS Specialist indicated the practice occurred nationally", "attrs": null, "canon": { "kind": { "name": "Title", "slug": "title", "status": "active", "canonId": "019de52c-f7dd-76d9-b848-b1f12bd85cf4", "version": 1, "description": "Slide title or headline." }, "tool": null, "subkind": { "name": "Headline", "slug": "headline", "status": "active", "canonId": "019de52c-fae1-7463-9a7c-d60668eced0d", "version": 1, "description": null }, "framework": null }, "subkind": "headline", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:12.693+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "a166abcb-fc4a-4adc-a09f-2ea421bc7203", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [ { "matchId": "ea0d28eb-092e-4fa8-a4e6-0de708e434f7", "evidence": "The slide uses expert testimony to expose operational inefficiencies and questionable business practices.", "framework": null, "confidence": 0.9, "extraction": { "at": "2026-05-02 20:12:12.693+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 79, "frameworkName": "fraud-exposure" } ], "arcBeats": [], "loops": [], "locked": true }, { "page": 80, "type": "tension", "title": "The slide uses a Q&A transcript format to substantiate the claim of system manipulation.", "function": "expose_contradiction", "rawType": "expose_contradiction", "block": null, "metadata": { "slideType": "expose_contradiction", "slideTypeCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-124c-75aa-984a-0a3d0d8fc8df", "version": 1, "description": null }, "function": "expose_contradiction", "functionCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-171f-776f-887c-73edaff4cf9c", "version": 1, "description": null }, "density": "balanced", "densityScore": 46, "componentCount": 4, "textChars": 3149, "nDataPoints": 0, "notes": "The slide uses a Q&A transcript format to substantiate the claim of system manipulation.", "elementsJson": [ "paragraph", "quote_block", "footnote" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:12:13.921+00", "seconds": 4.155, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/80", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-80", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": { "h": 0.45, "w": 0.86, "x": 0.07, "y": 0.48 }, "kind": "list", "text": "Allegedly manipulating internal systems to cover up their tracks to make it appear that no local specialists are available\nA: “Another thing that really disturbed me and was absolutely insane and blew my mind was how they assign people. Management was manipulating the system to pick and choose who was having to work...stuff like that was happening pretty regularly. But they kind of fucked up one day, and they didn’t realize it, I think, because they had taken everybody off the board. So, logistics was like, there’s nobody in Seattle to do this case - I don’t think it was Seattle to Seattle, but I think it was Tacoma to Seattle. And so, they flew someone in from LA to do the case. And then management was like, “Why are you there?” And she’s like, “You tell me.”\nQ: “You’re saying that they were supposed to pick people based on who’s on call?”\nA: “Yeah. It’s supposed to be based on what organ you do, and if you’re next up in the algorithm. And you have this certification; they can see the certifications - essentially, that’s how it was supposed to work. They’re manipulating the system to be like, we just want these people to work basically, so they were taking those certifications off of people. And that makes it look like they’re not on call, so it makes it look like there are less people able to work in this region.”\nQ: “You’re saying they were manipulating the system to make it seem like no one was available locally so they could fly in somebody.”\nA: “I just know that it looks like there was no one available here and then someone else had to fly here.”\nQ: “I see. So, they were making it seem like there was nobody available locally.”\nA: “They would have me, who is only doing liver, and then you have three other people who do liver and heart. So, they were manipulating it by taking the liver certifications from everyone else and only leaving me. And then I think they forgot that they were doing this, because then it would come to the point where if I was off or I was busy and they were like, “We have no one else to do liver now.” And then all of a sudden, they would sometimes find someone else and bring their certification back.” - Former TransMedics OCS specialist", "attrs": null, "canon": { "kind": { "name": "List", "slug": "list", "status": "active", "canonId": "019de52c-f94b-779b-a53b-fd4904a5f4d2", "version": 1, "description": "Bullet or numbered list." }, "tool": null, "subkind": { "name": "Bullet list", "slug": "bullet", "status": "active", "canonId": "019de52c-fc98-7169-a083-5cab805076ca", "version": 1, "description": null }, "framework": null }, "subkind": "bullet", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:13.921+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "8abca189-04f0-48cb-94ea-3e0e4411a682", "parentComponentId": null }, { "bbox": { "h": 0.15, "w": 0.86, "x": 0.07, "y": 0.32 }, "kind": "paragraph", "text": "The ex-employee described catching TransMedics in the act – “they kind of fucked up one day, and they didn’t realize it”: “another thing that really disturbed me and was absolutely insane and blew my mind was how they assign people...they’re manipulating the system...taking those certifications off people...that makes it look like they’re not on call, so it makes it look like there are less people able to work in this region...they were manipulating it by taking the liver certifications from everyone else....”", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:13.921+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "8b2ea458-eb27-4a89-b148-38d3bffaa874", "parentComponentId": null }, { "bbox": { "h": 0.02, "w": 0.25, "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:13.921+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "ec48961f-7ad6-4b26-a418-1e09dc8aa5cc", "parentComponentId": null }, { "bbox": { "h": 0.25, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "title", "text": "The most startling evidence provided by the second OCS Specialist suggests that TransMedics is doctoring records in its internal scheduling system to make it look like a local team is unavailable at a hub, or lacks the credentials for a particular organ - when in fact they are, and are certified - to create a pretext and cover-up for flying in nonlocal teams on its aircraft.", "attrs": null, "canon": { "kind": { "name": "Title", "slug": "title", "status": "active", "canonId": "019de52c-f7dd-76d9-b848-b1f12bd85cf4", "version": 1, "description": "Slide title or headline." }, "tool": null, "subkind": { "name": "Headline", "slug": "headline", "status": "active", "canonId": "019de52c-fae1-7463-9a7c-d60668eced0d", "version": 1, "description": null }, "framework": null }, "subkind": "headline", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:13.921+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "53af6fc6-8838-4d9e-9ac3-0a9eaae2176b", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [], "arcBeats": [], "loops": [], "locked": true }, { "page": 81, "type": "tension", "title": "The slide uses a combination of summary text and a direct, highlighted quote from a UCSF administrator to substantiate claims of fraudulent billing.", "function": "expose_contradiction", "rawType": "testimonial", "block": null, "metadata": { "slideType": "testimonial", "slideTypeCanon": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52d-0a2d-7782-8a48-7e84df92cc97", "version": 1, "description": null }, "function": "expose_contradiction", "functionCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-171f-776f-887c-73edaff4cf9c", "version": 1, "description": null }, "density": "overcrowded", "densityScore": 76, "componentCount": 8, "textChars": 3436, "nDataPoints": 2, "notes": "The slide uses a combination of summary text and a direct, highlighted quote from a UCSF administrator to substantiate claims of fraudulent billing.", "elementsJson": [ "paragraph", "quote_block", "footnote" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:12:14.589+00", "seconds": 4.749, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/81", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-81", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "UCSF expressed outrage at the business practices, portraying an out-of-control company pushing any angle to deceive, manipulate, and defraud them for >$100,000 to $200,000 in inexplicable air transport charges per case", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:03+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a975-e85731665baa", "parentComponentId": null }, { "bbox": { "h": 0.18, "w": 0.86, "x": 0.07, "y": 0.19 }, "kind": "paragraph", "text": "A transplant administrator corroborated the air transport billing scheme detailed by the two ex-OCS Specialists. UCSF expressed outrage at the business practices, portraying an out-of-control company pushing any angle to deceive, manipulate, and defraud them for >$100,000 to $200,000 in inexplicable air transport charges per case – on top of almost $100,000 for the device itself", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:14.589+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "e0d1bae9-1111-4328-be10-1aaec5d252b3", "parentComponentId": null }, { "bbox": { "h": 0.12, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "paragraph", "text": "UCSF is a pre-eminent transplant center and one of the highest-volume in the world. They are a significant TransMedics customer, but told us that they hope to eliminate their usage of the device in early 2025.", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:14.589+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "e8272724-4a0c-4cd0-b7bf-d9158589b71f", "parentComponentId": null }, { "bbox": { "h": 0.25, "w": 0.86, "x": 0.07, "y": 0.67 }, "kind": "quote", "text": "“Now, I don’t even bother. I would never even attempt to negotiate anything with them because they won’t negotiate. The transportation is a major problem for us. Part of the reason why our PO took so long to execute is because they just created their own transportation company and started flying - I hate flying their team all over the fucking country. I hate it. I hate paying for private jets to fly their surgeons all over. I don’t know why we have to pay for all these ridiculous transportation invoices. And I hate when, now that they’ve got their own transportation company, they just started flying their teams and sending us invoices. We can’t just pay a random—we can’t pay for flights from a company that we’re not contracted with. They have all these outstanding flight invoices because we don’t have a contract with...there’s very little transparency. Contracting with them for the transportation felt ridiculous because they couldn’t tell us what the rates were. Basically, we just get a piece of paper, an invoice that says you owe us for this flight going from here to here. It doesn’t say anything about what kind of aircraft it was, how long it was in the air—all this stuff. It’s just a number. They could have just made it up. I find that to be very frustrating.” – UCSF transplant administrator", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:14.589+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "127205e9-c0c2-4dfb-a166-f91c1d6f63b9", "parentComponentId": null }, { "bbox": { "h": 0.18, "w": 0.86, "x": 0.07, "y": 0.37 }, "kind": "quote", "text": "“I hate flying their team all over the fucking country. I hate it. I hate paying for private jets to fly their surgeons all over. I don’t know why we have to pay for all these ridiculous transportation invoices...they just started flying their teams and sending us these invoices”; “very little transparency...they couldn’t tell us what the rates were...we just get a piece of paper that says you owe us for this flight...it doesn’t say anything about what kind of aircraft it was, how long it was in the air...it’s just a number...they could have just made it up...very frustrating.”", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:14.589+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "76a761c1-811e-4106-8034-4848fe9e93b6", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "I hate flying their team all over the fucking country. I hate it. I hate paying for private jets to fly their surgeons all over. I don't know why we have to pay for all these ridiculous transportation invoices...they just started flying their teams and sending us these invoices; very little transparency...they couldn't tell us what the rates were...we just get a piece of paper that says you owe us for this flight...it doesn't say anything about what kind of aircraft it was, how long it was in the air...it's just a number...they could have just made it up...very frustrating. — UCSF transplant administrator", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:03+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a975-ec2a90076ad0", "parentComponentId": null }, { "bbox": { "h": 0.02, "w": 0.25, "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:14.589+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "d029f4e1-042e-48c5-a054-519188c62b26", "parentComponentId": null }, { "bbox": { "h": 0.03, "w": 0.45, "x": 0.07, "y": 0.63 }, "kind": "title", "text": "UCSF loathes TransMedics “ridiculous transportation invoices”", "attrs": null, "canon": { "kind": { "name": "Title", "slug": "title", "status": "active", "canonId": "019de52c-f7dd-76d9-b848-b1f12bd85cf4", "version": 1, "description": "Slide title or headline." }, "tool": null, "subkind": { "name": "Action title", "slug": "action-title", "status": "active", "canonId": "019de52c-fb31-734c-a0f5-a3935b73135d", "version": 1, "description": null }, "framework": null }, "subkind": "action-title", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:14.589+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "eb405e93-9e19-4497-97a2-55ab745ef595", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [], "arcBeats": [], "loops": [], "locked": true }, { "page": 82, "type": "tension", "title": "The slide uses direct quotes from interviews to highlight a lack of oversight and forced vendor usage.", "function": "expose_contradiction", "rawType": "expose_contradiction", "block": null, "metadata": { "slideType": "expose_contradiction", "slideTypeCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-124c-75aa-984a-0a3d0d8fc8df", "version": 1, "description": null }, "function": "expose_contradiction", "functionCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-171f-776f-887c-73edaff4cf9c", "version": 1, "description": null }, "density": "dense", "densityScore": 52, "componentCount": 6, "textChars": 2217, "nDataPoints": 0, "notes": "The slide uses direct quotes from interviews to highlight a lack of oversight and forced vendor usage.", "elementsJson": [ "paragraph", "quote_block", "footnote" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:12:13.357+00", "seconds": 3.039, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/82", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-82", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "the way that it currently works is no one's getting a quote from another vendor - they're just telling us what it's going to cost.", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:03+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a975-d0f040698dad", "parentComponentId": null }, { "bbox": { "h": 0.38, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "paragraph", "text": "UCSF stated that the out-of-control air travel invoices started recently, concurrent with the NOP business model and new jets, a sign that TransMedics is resorting to extreme measure to show growth; and that they were given no choice but to use the bundled air transport in order to utilize the device: “now that they’re using their own planes, these are the invoices that we’re getting...that was recent, in the last few months”; “it was messaged to me...that we didn’t have a choice...they’re just telling us what it’s going to cost.” The administrator bristled that TransMedics circumvents their attempts to control the cost, bypassing the administrators and pushing surgeons directly in the middle of the night to approve air transportation, an aggressive tactic alleged by other centers such as Massachusetts General – “there’s no oversight over how they manage logistics”", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:13.357+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "40e9f2f4-f602-491b-ac5e-cb41a122ff09", "parentComponentId": null }, { "bbox": { "h": 0.25, "w": 0.86, "x": 0.07, "y": 0.68 }, "kind": "quote", "text": "Circumventing UCSF administration/oversight by going to surgeons directly for last minute approval; no oversight “In the middle of the night, there’s an organ offer, and they come up with a transportation quote, and they send it to the surgeon for approval. Now, the surgeon isn’t going to stop what he’s doing and go and get other quotes from other transportation companies or from our preferred vendor. He’s just going to text back and say approved. Currently, I’m trying to get myself in the mix so that they come to me for approval so I can at least monitor it a little more closely, but that means I’m going to be keeping my phone on 24/7, waiting for TransMedics to call me with a flight quote. There’s no oversight over how they manage the logistics.” – UCSF transplant administrator", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:13.357+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "6d6f1689-b6fe-40f0-9ccc-c24a3d786a12", "parentComponentId": null }, { "bbox": { "h": 0.15, "w": 0.86, "x": 0.07, "y": 0.48 }, "kind": "quote", "text": "Invoices suddenly spiked after TransMedics bought their planes; UCSF told “we didn’t have a choice”", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:13.357+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "d3b36326-f0cc-4b13-8bd8-34e02babbfb6", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "“Now that they’re using their own planes, these are the invoices that we’re getting...that was recent, in the last few months”; “it was messaged to me...that we didn’t have a choice...they’re just telling us what it’s going to cost.” — UCSF transplant administrator", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:03+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a975-d5f2329be49f", "parentComponentId": null }, { "bbox": { "h": 0.02, "w": 0.3, "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:13.357+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "28d20705-a87d-4444-8e80-f3d0de3f4a04", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [], "arcBeats": [], "loops": [], "locked": true }, { "page": 83, "type": "tension", "title": "The slide uses a Q&A format to highlight specific instances of alleged fraud, emphasizing the lack of transparency and the financial impact of unnecessary air t", "function": "expose_contradiction", "rawType": "expose_contradiction", "block": null, "metadata": { "slideType": "expose_contradiction", "slideTypeCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-124c-75aa-984a-0a3d0d8fc8df", "version": 1, "description": null }, "function": "expose_contradiction", "functionCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-171f-776f-887c-73edaff4cf9c", "version": 1, "description": null }, "density": "balanced", "densityScore": 46, "componentCount": 7, "textChars": 1048, "nDataPoints": 0, "notes": "The slide uses a Q&A format to highlight specific instances of alleged fraud, emphasizing the lack of transparency and the financial impact of unnecessary air travel.", "elementsJson": [ "paragraph", "quote_block" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:12:14.631+00", "seconds": 4.121, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/83", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-83", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "UCSF’s billing experience lines up perfectly with the mechanism as described by former TransMedics employees – allagedly flying in teams to run up aircraft charges instead of using a local team that’s already available.", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:03+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a976-7cc14f126ddf", "parentComponentId": null }, { "bbox": { "h": 0.15, "w": 0.86, "x": 0.07, "y": 0.47 }, "kind": "list", "text": "Flying in teams across the country when local teams available; no transparency", "attrs": null, "canon": { "kind": { "name": "List", "slug": "list", "status": "active", "canonId": "019de52c-f94b-779b-a53b-fd4904a5f4d2", "version": 1, "description": "Bullet or numbered list." }, "tool": null, "subkind": { "name": "Bullet list", "slug": "bullet", "status": "active", "canonId": "019de52c-fc98-7169-a083-5cab805076ca", "version": 1, "description": null }, "framework": null }, "subkind": "bullet", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:14.631+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "0f1212df-9006-460b-a80b-bb5045f36548", "parentComponentId": null }, { "bbox": { "h": 0.25, "w": 0.86, "x": 0.07, "y": 0.65 }, "kind": "list", "text": "Flying in *multiple* planes when unnecessary", "attrs": null, "canon": { "kind": { "name": "List", "slug": "list", "status": "active", "canonId": "019de52c-f94b-779b-a53b-fd4904a5f4d2", "version": 1, "description": "Bullet or numbered list." }, "tool": null, "subkind": { "name": "Bullet list", "slug": "bullet", "status": "active", "canonId": "019de52c-fc98-7169-a083-5cab805076ca", "version": 1, "description": null }, "framework": null }, "subkind": "bullet", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:14.631+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "daf586bb-dc1a-439c-ad0c-68f203e902fc", "parentComponentId": null }, { "bbox": { "h": 0.25, "w": 0.86, "x": 0.07, "y": 0.15 }, "kind": "paragraph", "text": "UCSF recently came to realize that they are being duped, with TransMedics providing no explanation and allegedly flying in multiple planes when none were necessary.", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:14.631+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "27d515ac-0fb3-4079-a063-c66a4c68c829", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "There’s no transparency...this just started happening...they’re supposed to be invoicing us with flight times and stuff like that...there’s zero information...flying their staff from multiple locations to a case...I naively thought that they had a team here...then I realized we are flying in people from other locations...it really is ridiculous. — UCSF transplant administrator", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:03+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a976-8165173c52e8", "parentComponentId": null }, { "bbox": { "h": 0.03, "w": 0.3, "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:14.631+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "c3849740-2147-4464-8f0e-7add4ce00e0f", "parentComponentId": null }, { "bbox": { "h": 0.12, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "title", "text": "UCSF’s billing experience lines up perfectly with the mechanism as described by former TransMedics employees", "attrs": null, "canon": { "kind": { "name": "Title", "slug": "title", "status": "active", "canonId": "019de52c-f7dd-76d9-b848-b1f12bd85cf4", "version": 1, "description": "Slide title or headline." }, "tool": null, "subkind": { "name": "Headline", "slug": "headline", "status": "active", "canonId": "019de52c-fae1-7463-9a7c-d60668eced0d", "version": 1, "description": null }, "framework": null }, "subkind": "headline", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:14.631+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "ce4c332e-6ec4-4028-b45a-aae3aa4aede9", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [ { "matchId": "05cf8afd-a6c6-4400-bb27-7e5616e327b5", "evidence": "The slide explicitly documents an alleged scheme of billing for unnecessary services (flights) to inflate costs.", "framework": null, "confidence": 0.95, "extraction": { "at": "2026-05-02 20:12:14.631+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 83, "frameworkName": "fraud-exposure" } ], "arcBeats": [], "loops": [], "locked": true }, { "page": 84, "type": "tension", "title": "The slide uses a Q&A format to highlight skepticism about TransMedics' billing practices.", "function": "expose_contradiction", "rawType": "expose_contradiction", "block": null, "metadata": { "slideType": "expose_contradiction", "slideTypeCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-124c-75aa-984a-0a3d0d8fc8df", "version": 1, "description": null }, "function": "expose_contradiction", "functionCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-171f-776f-887c-73edaff4cf9c", "version": 1, "description": null }, "density": "dense", "densityScore": 54, "componentCount": 7, "textChars": 1120, "nDataPoints": 6, "notes": "The slide uses a Q&A format to highlight skepticism about TransMedics' billing practices.", "elementsJson": [ "paragraph", "quote_block", "footnote" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:12:13.618+00", "seconds": 3.017, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/84", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-84", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "Now, do I have any way of validating whether that was true...do they have an incentive to lie about it...yes, they do...you just have to trust what they’re telling you...it’s ridiculous...it’s infuriating.", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:04+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a976-e8f681d94b7b", "parentComponentId": null }, { "bbox": null, "kind": "metric", "text": "air transport costs: $160,000", "attrs": null, "canon": { "kind": { "name": "Metric", "slug": "metric", "status": "active", "canonId": "019de52c-f923-73bf-8081-d0b1a8c5264d", "version": 1, "description": "Big-number or KPI value." }, "tool": { "name": "Quantification", "slug": "quantification", "status": "active", "bestFor": null, "canonId": "019dd9e1-47ab-72ce-a079-aab1f5299e88", "version": 1, "bodyDocId": null, "description": "Translating a claim into numbers, charts, or tables.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": "primary", "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:04+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a976-f12466491ba2", "parentComponentId": null }, { "bbox": { "h": 0.18, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "paragraph", "text": "UCSF provided multiple examples where several planes were dispatched for the same organ recovery, with air transport charges of $160,000, and expressed skepticism that TransMedics explanations were truthful...", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:13.618+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "97da8455-b7fb-494e-82ef-05517e9c6b8d", "parentComponentId": null }, { "bbox": { "h": 0.35, "w": 0.86, "x": 0.07, "y": 0.27 }, "kind": "quote", "text": "Example of $160,000 in air transport charges with no visibility or ability to verify... Q: Explain to me how you ended up having two planes needed? A: We had a donor in Alaska...", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:13.618+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "d2837820-2759-41b4-8596-3aebd5108a7c", "parentComponentId": null }, { "bbox": { "h": 0.25, "w": 0.86, "x": 0.07, "y": 0.65 }, "kind": "quote", "text": "Air travel invoices can be $40,000 to over $100,000 per case; $200K total with device... Q: So, $40-100k purely air travel on top of the $90,000, so it could cost up to $200,000? A: Yeah, it's ridiculous.", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:13.618+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "e74d41d4-644d-4c2a-b279-e82dd246ab5f", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "“Now, do I have any way of validating whether that was true...do they have an incentive to lie about it...yes, they do...you just have to trust what they’re telling you...it’s ridiculous...it’s infuriating.” — UCSF transplant administrator", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:04+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a976-ef23c5e88129", "parentComponentId": null }, { "bbox": { "h": 0.03, "w": 0.3, "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:13.618+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "73e26030-55fc-4057-9749-731f34368896", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [ { "matchId": "2a2ce627-aaa8-47ee-bedc-cb237ad559ae", "evidence": "The slide explicitly frames the content as exposing a scheme and questioning the truthfulness of billing practices.", "framework": null, "confidence": 0.9, "extraction": { "at": "2026-05-02 20:12:13.618+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 84, "frameworkName": "fraud-exposure" } ], "arcBeats": [], "loops": [], "locked": true }, { "page": 85, "type": "tension", "title": "The slide presents a Q&A style interview excerpt to support a claim of extortion/fraud.", "function": "expose_contradiction", "rawType": "expose_contradiction", "block": null, "metadata": { "slideType": "expose_contradiction", "slideTypeCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-124c-75aa-984a-0a3d0d8fc8df", "version": 1, "description": null }, "function": "expose_contradiction", "functionCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-171f-776f-887c-73edaff4cf9c", "version": 1, "description": null }, "density": "dense", "densityScore": 53, "componentCount": 6, "textChars": 2506, "nDataPoints": 0, "notes": "The slide presents a Q&A style interview excerpt to support a claim of extortion/fraud.", "elementsJson": [ "paragraph", "quote_block", "footnote" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:12:14.686+00", "seconds": 3.985, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/85", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-85", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": { "h": 0.03, "w": 0.86, "x": 0.07, "y": 0.59 }, "kind": "callout", "text": "OPO and UCSF forced to fly multiple planes even though right next to a TransMedics depot; threatening access to the technology", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": null, "subkind": { "name": "Primary callout", "slug": "primary", "status": "active", "canonId": "019de52c-fbd1-70eb-a9ce-8997f8674c1d", "version": 1, "description": null }, "framework": null }, "subkind": "primary", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:14.686+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "c6fdfa98-7638-4aaa-acb5-a429aaaf9768", "parentComponentId": null }, { "bbox": null, "kind": "callout", "text": "TransMedics has now essentially forced the transplant center; if you want access to this technology for their patient, then the transplant center is not able to share a plane with us...they have to go and use the TransMedics-owned and operated aircraft.", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:04+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a976-a04b5a829f88", "parentComponentId": null }, { "bbox": { "h": 0.45, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "paragraph", "text": "A West Coast organ procurement organization (OPO) confirmed and elaborated upon UCSF’s description of conduct that we interpret as fraud, replying “yeah, oh yeah” when we used the label. We interviewed an industry veteran and executive at the OPO, who stated that the Gosar letter is correct and that centers are coerced into paying for multiple aircraft. TransMedics has a hub in San Ramon, CA “across the street” from the OPO. Previously, if an organ was available in Nevada, for example, the OPO and UCSF would charter and share a single plane and bring back three organs - two kidneys and liver - from a single donor. However, TransMedics now allegedly forces the OPO and UCSF to pay for a separate plane for their device and technician, necessitating two planes by refusing to share one: “TransMedics has now essentially forced the transplant center...if you want access to this technology for their patient, then the transplant center is not able to share a plane with us...they have to go and use the TransMedics-owned and operated aircraft.”", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:14.686+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "9fcdd331-8995-4c15-bbef-ca2dacb7860c", "parentComponentId": null }, { "bbox": { "h": 0.25, "w": 0.86, "x": 0.07, "y": 0.62 }, "kind": "quote", "text": "A: “We’re based in the San Francisco Bay area. Let’s say that we have an organ donor at a hospital in Reno, and the organ is going to go to UCSF for transplant. You probably saw this mentioned in that letter. Historically, we would charter one plane, and we would all share it together. The UCSF team would join, they would get on a plane. Our team would get on there. We’d go to the OR and procure two kidneys and a liver, and we’re able to bring the three organs to the Bay area on that one plane. TransMedics has now essentially forced the transplant center; if you want access to this technology for their patient, then the transplant center is not able to share a plane with us. They have to go and use the TransMedics-owned and operated aircraft. Their depot is right across the street from our office, our clinical office space.” Q: “This sound like extortion.” A: “Yeah, oh yeah.” – Executive at a West Coast OPO, longtime industry veteran", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:14.686+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "3da0a56b-f65b-4b5d-99ea-a6110643689f", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "“Yeah, oh yeah.” — Executive at a West Coast OPO, longtime industry veteran", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:04+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a976-a71bfdfb0506", "parentComponentId": null }, { "bbox": { "h": 0.02, "w": 0.25, "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:14.686+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "aef0ebc9-edcf-437e-9dd8-7e6f38d12c8d", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [ { "matchId": "d91cb24e-a13b-46f5-9318-4b11faa5949a", "evidence": "The slide explicitly frames the conduct as 'fraud' and 'extortion' based on expert testimony.", "framework": null, "confidence": 0.9, "extraction": { "at": "2026-05-02 20:12:14.686+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 85, "frameworkName": "fraud-exposure" } ], "arcBeats": [], "loops": [], "locked": true }, { "page": 86, "type": "tension", "title": "The slide highlights a specific geographical proximity (San Ramon) to argue that TransMedics' operational choices are inefficient and costly for transplant cent", "function": "expose_contradiction", "rawType": "expose_contradiction", "block": null, "metadata": { "slideType": "expose_contradiction", "slideTypeCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-124c-75aa-984a-0a3d0d8fc8df", "version": 1, "description": null }, "function": "expose_contradiction", "functionCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-171f-776f-887c-73edaff4cf9c", "version": 1, "description": null }, "density": "balanced", "densityScore": 49, "componentCount": 7, "textChars": 1198, "nDataPoints": 0, "notes": "The slide highlights a specific geographical proximity (San Ramon) to argue that TransMedics' operational choices are inefficient and costly for transplant centers.", "elementsJson": [ "paragraph", "quote_block", "map", "callout_box" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:12:15.588+00", "seconds": 4.84, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/86", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-86", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": { "h": 0.1, "w": 0.3, "x": 0.35, "y": 0.76 }, "kind": "callout", "text": "TransMedics hub is a short walk from OPO facility", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": null, "subkind": { "name": "Primary callout", "slug": "primary", "status": "active", "canonId": "019de52c-fbd1-70eb-a9ce-8997f8674c1d", "version": 1, "description": null }, "framework": null }, "subkind": "primary", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:15.588+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "4e89331a-a2f5-4371-90e3-8193b21103ce", "parentComponentId": null }, { "bbox": { "h": 0.22, "w": 0.25, "x": 0.07, "y": 0.73 }, "kind": "image", "text": null, "attrs": null, "canon": { "kind": { "name": "Image", "slug": "image", "status": "active", "canonId": "019de52c-f978-701f-a720-51d029d769e7", "version": 1, "description": "Photo, illustration, screenshot or icon." }, "tool": null, "subkind": { "name": "Map", "slug": "map", "status": "active", "canonId": "019de52c-fe4d-77bd-b0a4-d72d58b9e5a4", "version": 1, "description": null }, "framework": null }, "subkind": "map", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:15.588+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "488583b1-1e37-4b4a-b19d-2bfb7e9cc76a", "parentComponentId": null }, { "bbox": { "h": 0.25, "w": 0.86, "x": 0.07, "y": 0.22 }, "kind": "paragraph", "text": "Google Maps shows that TransMedics’ hub in San Ramon, CA is a 3-minute drive or short walk from the OPO, per a hub address in a job posting. Rather than simply sharing one plane with UCSF and the OPO, the executive described a tragicomical scene...", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:15.588+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "3675689e-7f47-4a10-bc5e-042bf7f82440", "parentComponentId": null }, { "bbox": { "h": 0.25, "w": 0.86, "x": 0.07, "y": 0.48 }, "kind": "quote", "text": "OPO and UCSF forced to fly multiple planes even though right next to a TransMedics depot; threatening access to the technology Q: “You’re saying TransMedics has a depot across the street?” A: “They have these hubs all over the country...\"", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:15.588+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "f8c8b6f2-d80a-4dc8-96d5-de58be63bd35", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "“you can see our team walking out and getting in the car and their team walking out and getting in their car, and we drive to the airport together, and everybody gets onto their own aircraft, and we charter two aircraft, and that’s how we get to Reno...and then two planes come right back side by side, but TransMedics is in their plane and they pass all that cost to the transplant center.” — Executive at a leading West Coast OPO, longtime industry veteran", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:04+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a977-220020c8c51d", "parentComponentId": null }, { "bbox": { "h": 0.03, "w": 0.35, "x": 0.07, "y": 0.96 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts; Google maps", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:15.588+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "9f224136-a117-4343-b51d-c5f41f3b4f19", "parentComponentId": null }, { "bbox": { "h": 0.15, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "title", "text": "TransMedics conduct makes a mockery of the CEO’s reply to Congressman Gosar, cloaking itself in altruistic garb as trying to save lives.", "attrs": null, "canon": { "kind": { "name": "Title", "slug": "title", "status": "active", "canonId": "019de52c-f7dd-76d9-b848-b1f12bd85cf4", "version": 1, "description": "Slide title or headline." }, "tool": null, "subkind": { "name": "Headline", "slug": "headline", "status": "active", "canonId": "019de52c-fae1-7463-9a7c-d60668eced0d", "version": 1, "description": null }, "framework": null }, "subkind": "headline", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:15.588+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "7b40af1f-16e5-41e2-a21c-31fd369c082a", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [ { "matchId": "86496d74-8e7a-465f-8c7b-236acec696e0", "evidence": "The slide explicitly aims to expose a contradiction between corporate claims and operational reality.", "framework": null, "confidence": 0.9, "extraction": { "at": "2026-05-02 20:12:15.588+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 86, "frameworkName": "fraud-exposure" } ], "arcBeats": [], "loops": [], "locked": true }, { "page": 87, "type": "tension", "title": "The slide uses a Q&A format to provide primary source evidence for the claims made in the headline.", "function": "expose_contradiction", "rawType": "expose_contradiction", "block": null, "metadata": { "slideType": "expose_contradiction", "slideTypeCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-124c-75aa-984a-0a3d0d8fc8df", "version": 1, "description": null }, "function": "expose_contradiction", "functionCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-171f-776f-887c-73edaff4cf9c", "version": 1, "description": null }, "density": "dense", "densityScore": 54, "componentCount": 6, "textChars": 2756, "nDataPoints": 0, "notes": "The slide uses a Q&A format to provide primary source evidence for the claims made in the headline.", "elementsJson": [ "paragraph", "quote_block", "footnote" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:12:14.264+00", "seconds": 3.509, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/87", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-87", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "Three planes charged to transplant center; multiple ways that TransMedics coerces centers", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:04+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a977-3403b4c4abe5", "parentComponentId": null }, { "bbox": { "h": 0.03, "w": 0.65, "x": 0.07, "y": 0.41 }, "kind": "paragraph", "text": "Three planes charged to transplant center; multiple ways that TransMedics coerces centers", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:14.264+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "d4186e70-0863-45a9-a5b0-48cd3c954e32", "parentComponentId": null }, { "bbox": { "h": 0.35, "w": 0.86, "x": 0.07, "y": 0.45 }, "kind": "quote", "text": "Q: “It sounds like there are DOJ claims and indictments waiting to happen, which is kind of what Gosar’s letter was saying.” A: “Yeah, it’s crazy. They’ll deny it. There are times where—again, we might have that donor in Reno—perhaps we have a machine available here, and there are times when we have an OR and three planes land for the TransMedics operation. One brought the machine from San Ramon. The other one, they sent a surgeon in from Phoenix, and the other plane brought in an OCS specialist, their technician, to operate the machine from San Diego. It is crazy what they’re doing. I don’t understand.” Q: “So, they’re charging people for three planes.” A: “They charge the fee for the disposable, the charge the transplant centers, to my knowledge, a $10,000 fee for the technician that operates the device, and as far as I know at this point, they’re not training anyone other than their own staff to operate the device. They also won’t sell you the device. Then they’ll charge you $10,000 for the surgeon when they secure a surgeon, and then on top of that, they’ll pass along to the transplant center the cost of any flight that came in. So, sometimes, three flights get passed on to the transplant center.” – Executive at a leading West Coast OPO, longtime industry veteran", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:14.264+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "2718d4d4-7466-4c82-a552-fa543c5429ef", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "“Yeah, it’s crazy. They’ll deny it. There are times where—again, we might have that donor in Reno—perhaps they have a machine available here, and there are times when we have an OR and three planes land for the TransMedics operation. One brought the machine from San Ramon. The other one, they sent a surgeon in from Phoenix, and the other plane brought in an OCS specialist, their technician, to operate the machine from San Diego. It is crazy what they’re doing. I don’t understand.” — Executive at a leading West Coast OPO, longtime industry veteran", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:04+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a977-3b237f9bf46d", "parentComponentId": null }, { "bbox": { "h": 0.02, "w": 0.25, "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:14.264+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "b8c5ba30-e153-4573-83bb-665355055099", "parentComponentId": null }, { "bbox": { "h": 0.28, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "title", "text": "The OPO executive described TransMedics conduct as “crazy…they’ll deny it.” He provided examples when “three planes land for the TransMedics operation” for a single case and “get passed on to the transplant center” – one bringing the device from their hub in San Ramon, CA; one with a procurement surgeon flown in from Phoenix, AZ; and a third carrying the device technician from San Diego, CA – “it is crazy what they’re doing…I don’t understand.” He indicated that centers have no other option as TransMedics no longer allows them to operate the device themselves – “they’re not training anyone other than their own staff to operate the device…they also won’t sell you the device.”", "attrs": null, "canon": { "kind": { "name": "Title", "slug": "title", "status": "active", "canonId": "019de52c-f7dd-76d9-b848-b1f12bd85cf4", "version": 1, "description": "Slide title or headline." }, "tool": null, "subkind": { "name": "Headline", "slug": "headline", "status": "active", "canonId": "019de52c-fae1-7463-9a7c-d60668eced0d", "version": 1, "description": null }, "framework": null }, "subkind": "headline", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:14.264+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "cf06da57-2d0c-4841-a7be-ac766e54b014", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [], "arcBeats": [], "loops": [], "locked": true }, { "page": 88, "type": "tension", "title": "The slide uses a Q&A format to build a narrative of 'extortion' and 'wasted organs' against the subject company.", "function": "name_villain", "rawType": "villain_critique", "block": null, "metadata": { "slideType": "villain_critique", "slideTypeCanon": { "name": "Villain critique", "slug": "villain_critique", "status": "active", "canonId": "019de52d-10bc-7136-bf20-09de59d17447", "version": 1, "description": null }, "function": "name_villain", "functionCanon": { "name": "Name villain", "slug": "name_villain", "status": "active", "canonId": "019de52d-1746-70d6-bc58-5eeaf5865526", "version": 1, "description": null }, "density": "balanced", "densityScore": 39, "componentCount": 5, "textChars": 1407, "nDataPoints": 0, "notes": "The slide uses a Q&A format to build a narrative of 'extortion' and 'wasted organs' against the subject company.", "elementsJson": [ "paragraph", "quote_block", "footnote" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:12:13.578+00", "seconds": 2.749, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/88", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-88", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "The OPO expressed fury, stating that TransMedics conduct resulted in wasted organs that were viable and could have saved lives, by refusing access to the device unless they commit to paying for multiple aircraft and “mystery fees” – what a reasonable person may label textbook extortion", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:04+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a977-7e8d74f896c2", "parentComponentId": null }, { "bbox": { "h": 0.45, "w": 0.86, "x": 0.07, "y": 0.45 }, "kind": "paragraph", "text": "Lost organs by refusing OPO's access to device unless they pay for flights and mystery/hidden fees; no visibility into their fees Q: A: \"They come in and say that they're in it to increase the number of available organs transplanted to save lives - all of that stuff...\"", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:13.578+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "ad51bd2c-71cc-4cfd-be83-ccf4ff111b45", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "“They come in and say that they’re in it to increase the number of available organs transplanted to save lives - all of that stuff. We might have an organ donor in Reno... They will just flat-out say no... they will blanketly refuse to move... there are these hidden—for the transplant centers, it’s all these mystery fees that you don’t really know how many flights you’re going to pay for until they tell you how many flights they’ve used.” — Executive at a leading West Coast OPO, longtime industry veteran", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:04+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a977-81af19cd845e", "parentComponentId": null }, { "bbox": { "h": 0.03, "w": 0.3, "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:13.578+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "fc774a75-3064-4a1f-be9c-981b42b6a558", "parentComponentId": null }, { "bbox": { "h": 0.25, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "title", "text": "The OPO expressed fury, stating that TransMedics conduct resulted in wasted organs that were viable and could have saved lives, by refusing access to the device unless they commit to paying for multiple aircraft and “mystery fees” – what a reasonable person may label textbook extortion", "attrs": null, "canon": { "kind": { "name": "Title", "slug": "title", "status": "active", "canonId": "019de52c-f7dd-76d9-b848-b1f12bd85cf4", "version": 1, "description": "Slide title or headline." }, "tool": null, "subkind": { "name": "Headline", "slug": "headline", "status": "active", "canonId": "019de52c-fae1-7463-9a7c-d60668eced0d", "version": 1, "description": null }, "framework": null }, "subkind": "headline", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:13.578+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "b36d8a3f-475d-4183-9d19-cf6f2ac5379d", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [], "arcBeats": [], "loops": [], "locked": true }, { "page": 89, "type": "tension", "title": "The slide uses a highlight-heavy block quote to emphasize the alleged extortion and fraudulent billing.", "function": "expose_contradiction", "rawType": "expose_contradiction", "block": null, "metadata": { "slideType": "expose_contradiction", "slideTypeCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-124c-75aa-984a-0a3d0d8fc8df", "version": 1, "description": null }, "function": "expose_contradiction", "functionCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-171f-776f-887c-73edaff4cf9c", "version": 1, "description": null }, "density": "dense", "densityScore": 62, "componentCount": 6, "textChars": 4364, "nDataPoints": 4, "notes": "The slide uses a highlight-heavy block quote to emphasize the alleged extortion and fraudulent billing.", "elementsJson": [ "paragraph", "quote_block", "footnote" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:12:18.891+00", "seconds": 7.985, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/89", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-89", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": { "h": 0.03, "w": 0.86, "x": 0.07, "y": 0.41 }, "kind": "callout", "text": "Allegedly held a center hostage after sending $3-400K in charges that were not agreed to", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": null, "subkind": { "name": "Primary callout", "slug": "primary", "status": "active", "canonId": "019de52c-fbd1-70eb-a9ce-8997f8674c1d", "version": 1, "description": null }, "framework": null }, "subkind": "primary", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:18.891+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "96908686-8c03-4165-9dff-463ca3aab381", "parentComponentId": null }, { "bbox": null, "kind": "callout", "text": "I just found it very disturbing that they come in with these threats...holding them hostage.", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:05+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a978-5f7cca658787", "parentComponentId": null }, { "bbox": { "h": 0.45, "w": 0.86, "x": 0.07, "y": 0.45 }, "kind": "paragraph", "text": "“Most recently, I got a message from [redacted]. [Redacted] was a heavy user of TransMedics liver machine. They went into a contract, and then TransMedics started operating in this really inefficient way that we discussed earlier where they sometimes will commit to going to a donor maybe in Reno, but they show up with three planes, and so then [redacted] believed that they just ordered a $100,000 machine and service, but then a month later, they get $300,000, $400,000 worth of invoices because TransMedics is passing along all of these aircraft fees and the ground transportation fees to them. This colleague was explaining to me the situation where when they went into contract, none of this was agreed on. And so, internally, they were having trouble getting this routed appropriately through procurement at the hospital and needing to renegotiate or get it into the agreement. And so, it had been several months where they had not yet been able to reimburse TransMedics for the flight charges that they were trying to pass through to them. Well, Waleed reaches out to this transplant center, which is the largest transplant center in [redacted], and essentially gives them 48 hours to pay all of these flight charges that they never agreed to pay. TransMedics went on and incurred the charges on their own and then tried to pass along the charges to [redacted]. And essentially tells them that they are going to shut off access to the machine to them. They never even agreed to these expenses...I just found it very disturbing that they come in with these threats that their patients will no longer have access to these lifesaving grafts because they now want to be reimbursed for these flights retrospectively that they acknowledged was never in the agreement, but the incurred the charges and they want them to be paid anyway. And holding them hostage.” – Executive at a leading West Coast OPO, longtime industry veteran", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:18.891+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "a91e8210-87b8-4775-bc04-7c9d55e86e81", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "“Most recently, I got a message from [redacted]. [Redacted] was a heavy user of TransMedics liver machine. They went into a contract, and then TransMedics started operating in this really inefficient way that we discussed earlier where they sometimes will commit to going to a donor maybe in Reno, but they show up with three planes, and so then [redacted] believed that they just ordered a $100,000 machine and service, but then a month later, they get $300,000, $400,000 worth of invoices because TransMedics is passing along all of these aircraft fees and the ground transportation fees to them. This colleague was explaining to me the situation where when they went into contract, none of this was agreed on. And so, internally, they were having trouble getting this routed appropriately through procurement at the hospital and needing to renegotiate or get it into the agreement. And so, it had been several months where they had not yet been able to reimburse TransMedics for the flight charges that they were trying to pass through to them. Well, Waleed reaches out to this transplant center, which is the largest transplant center in [redacted], and essentially gives them 48 hours to pay all of these flight charges that they never agreed to pay. TransMedics went on and incurred the charges on their own and then tried to pass along the charges to [redacted]. And essentially tells them that they are going to shut off access to the machine to them. They never even agreed to these expenses...I just found it very disturbing that they come in with these threats that their patients will no longer have access to these lifesaving grafts because they now want to be reimbursed for these flights retrospectively that they acknowledged was never in the agreement, but the incurred the charges and they want them to be paid anyway. And holding them hostage.” — Executive at a leading West Coast OPO, longtime industry veteran", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:05+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a978-60387c1b9448", "parentComponentId": null }, { "bbox": { "h": 0.02, "w": 0.25, "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:18.891+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "423047fa-abbb-47b3-9852-c40279439b2a", "parentComponentId": null }, { "bbox": { "h": 0.25, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "title", "text": "The OPO confirmed one of the most damning anecdotes we heard, where TransMedics allegedly extorted a center into paying for “$300,000, $400,000 worth of invoices” that appear fraudulent, giving them 48 hours to pay or “they are going to shut off access to the machine”", "attrs": null, "canon": { "kind": { "name": "Title", "slug": "title", "status": "active", "canonId": "019de52c-f7dd-76d9-b848-b1f12bd85cf4", "version": 1, "description": "Slide title or headline." }, "tool": null, "subkind": { "name": "Headline", "slug": "headline", "status": "active", "canonId": "019de52c-fae1-7463-9a7c-d60668eced0d", "version": 1, "description": null }, "framework": null }, "subkind": "headline", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:18.891+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "89b896b7-c9b6-4b01-b1e3-5e4dc5852ed6", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [ { "matchId": "fec478d3-6d60-4746-ba8c-d5469b75a23e", "evidence": "The slide explicitly documents an allegation of fraudulent billing and extortion.", "framework": null, "confidence": 0.9, "extraction": { "at": "2026-05-02 20:12:18.891+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 89, "frameworkName": "fraud-exposure" } ], "arcBeats": [], "loops": [], "locked": true }, { "page": 90, "type": "tension", "title": "The slide uses a testimonial to highlight a shift from a collaborative 'backyard relationship' to a profit-driven 'utilization at all costs' model.", "function": "expose_contradiction", "rawType": "expose_contradiction", "block": null, "metadata": { "slideType": "expose_contradiction", "slideTypeCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-124c-75aa-984a-0a3d0d8fc8df", "version": 1, "description": null }, "function": "expose_contradiction", "functionCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-171f-776f-887c-73edaff4cf9c", "version": 1, "description": null }, "density": "overcrowded", "densityScore": 77, "componentCount": 8, "textChars": 3806, "nDataPoints": 2, "notes": "The slide uses a testimonial to highlight a shift from a collaborative 'backyard relationship' to a profit-driven 'utilization at all costs' model.", "elementsJson": [ "paragraph", "quote_block", "footnote" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:12:14.387+00", "seconds": 3.469, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/90", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-90", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": { "h": 0.05, "w": 0.86, "x": 0.07, "y": 0.52 }, "kind": "callout", "text": "MGH soured on the relationship, bypassing protocols to run up the cost to $200K; “utilization at all costs”", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": null, "subkind": { "name": "Primary callout", "slug": "primary", "status": "active", "canonId": "019de52c-fbd1-70eb-a9ce-8997f8674c1d", "version": 1, "description": null }, "framework": null }, "subkind": "primary", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:14.387+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "b8402b96-a2ea-4c0e-849a-d77a42300fb5", "parentComponentId": null }, { "bbox": null, "kind": "callout", "text": "MGH soured on the relationship, bypassing protocols to run up the cost to $200K; \"utilization at all costs\"", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:05+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a978-19ae3f671232", "parentComponentId": null }, { "bbox": { "h": 0.15, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "paragraph", "text": "Massachusetts General Hospital, a pre-eminent high-volume transplant center, detailed the exact same abuses on the east coast that UCSF and the OPO alleged on the west coast – indicating that TransMedics’ scheme is national in scope.", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:14.387+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "1d798d61-308f-42bd-8288-d874a6beed5b", "parentComponentId": null }, { "bbox": { "h": 0.15, "w": 0.86, "x": 0.07, "y": 0.32 }, "kind": "paragraph", "text": "We interviewed a longtime transplant administrator, who described – echoing his peer at UCSF – how TransMedics circumvents their controls and he has to “get involved at 2AM on a Saturday” because MGH suddenly gets hit with outrageous charges for a routine organ recovery: “I find out down the line...it’s upwards of $180,000 to almost a $200,000 all-in with the procurement team decision that was made without any one of us involved.”", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:14.387+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "96d89c46-f61b-4462-aaf4-cbf4edf39aec", "parentComponentId": null }, { "bbox": { "h": 0.1, "w": 0.86, "x": 0.07, "y": 0.22 }, "kind": "paragraph", "text": "MGH is one of TransMedics earliest and closest customers – “we were up front, first users of the device because we had a backyard relationship” – but stated that the company’s “tune has changed” and it’s now “about utilization at all costs.”", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:14.387+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "f05e2140-91f7-4dd2-8817-339fb6de4d3e", "parentComponentId": null }, { "bbox": { "h": 0.35, "w": 0.86, "x": 0.07, "y": 0.57 }, "kind": "quote", "text": "“When I first became involved with the discussion of partnering with TransMedics for their liver and their heart OCS device, and then lungs after FDA approval...yes, it does come at a cost, but we were upfront, first users of the device because we had a backyard relationship with them, but also, we, at my institution, were trying to be innovators across all fronts, and that’s also one of the reasons why we wanted to partner with them. As the relationship evolved over the years, the tune has changed. It has become less about what can we do together and trying to figure out the best way, the best logistical setup, and the best-aligned incentives to achieve our mutual goals to become more about utilization at all costs, meaning sometimes there would be situations where I get involved at 2:00AM on a Saturday because so-and-so had said we want to use the OCS device and then now the entire team takes a hold of the entire logistical setup and I find out down the line that something where it’s a typical we fly out the teams, we take the procurement team with us with the modules, and now it’s upwards of like $180,000 to almost a $200,000 all-in with the procurement team decision that was made without any one of us involved.” – Veteran transplant administrator/executive at Massachusetts General Hospital", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:14.387+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "accfb9e1-e283-43cf-b83f-b888f3921c18", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "\"When I first became involved with the discussion of partnering with TransMedics for their liver and their heart OCS device, and then lungs after FDA approval...yes, it does come at a cost, but we were upfront, first users of the device because we had a backyard relationship with them, but also, we, at my institution, were trying to be innovators across all fronts, and that's also one of the reasons why we wanted to partner with them. As the relationship evolved over the years, the tune has changed. It has become less about what can we do together and trying to figure out the best way, the best logistical setup, and the best-aligned incentives to achieve our mutual goals to become more about utilization at all costs, meaning sometimes there would be situations where I get involved at 2:00AM on a Saturday because so-and-so had said we want to use the OCS device and then now the entire team takes a hold of the entire logistical setup and I find out down the line that something where it's a typical we fly out the teams, we take the procurement team with us with the modules, and now it's upwards of like $180,000 to almost a $200,000 all-in with the procurement team decision that was made without any one of us involved.\" — Veteran transplant administrator/executive at Massachusetts General Hospital", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:05+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a978-1e3ed10723de", "parentComponentId": null }, { "bbox": { "h": 0.02, "w": 0.3, "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:14.387+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "cf9cf686-2fdd-450a-adbc-a180077c0fcf", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [], "arcBeats": [], "loops": [], "locked": true }, { "page": 91, "type": "tension", "title": "The slide uses a combination of summary text and a direct, highlighted quote to establish a pattern of recidivist behavior by the subject company.", "function": "name_villain", "rawType": "villain_critique", "block": null, "metadata": { "slideType": "villain_critique", "slideTypeCanon": { "name": "Villain critique", "slug": "villain_critique", "status": "active", "canonId": "019de52d-10bc-7136-bf20-09de59d17447", "version": 1, "description": null }, "function": "name_villain", "functionCanon": { "name": "Name villain", "slug": "name_villain", "status": "active", "canonId": "019de52d-1746-70d6-bc58-5eeaf5865526", "version": 1, "description": null }, "density": "balanced", "densityScore": 43, "componentCount": 5, "textChars": 1733, "nDataPoints": 0, "notes": "The slide uses a combination of summary text and a direct, highlighted quote to establish a pattern of recidivist behavior by the subject company.", "elementsJson": [ "paragraph", "quote_block", "footnote" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:12:15.162+00", "seconds": 4.227, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/91", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-91", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "MGH employs a term called “Never Events” for outlier situations that should never occur, which happen with TransMedics “at a higher frequency...sometimes even a couple of times a week” where MGH is hit with extreme charges for an organ recovery.", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:05+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a977-9423c4226adb", "parentComponentId": null }, { "bbox": { "h": 0.25, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "paragraph", "text": "MGH employs a term called “Never Events” for outlier situations that should never occur, which happen with TransMedics “at a higher frequency...sometimes even a couple of times a week” where MGH is hit with extreme charges for an organ recovery.", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:15.162+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "a3b9930e-8f98-46b0-8c3e-41bdb9af6abf", "parentComponentId": null }, { "bbox": { "h": 0.35, "w": 0.86, "x": 0.07, "y": 0.55 }, "kind": "quote", "text": "“Never events” occur on a regular basis, monthly or “couple of times a week,” where “cost threshold” crossed...", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:15.162+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "1a53199c-114f-4b32-a9cf-a188c00c78d8", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "“And we've had a couple of these situations in the past where I've had to have very candid conversations with their leadership. Many times, there have been situations where they've apologized profusely, so sorry that this has occurred, never our intention, won't ever happen again. We won't have any disagreements at all for a couple of months, and then again, there will be a situation where someone had made a call independent of our surgeons, and it just would continue to occur at a higher frequency, almost once a month, sometimes even a couple of times a week where now I have to get involved whenever there's a certain threshold that gets crossed as far as costs go where I would then have to bypass the entire team, go straight up to their leadership, and say, this is not what we discussed, we either need to end this or address this,...these types of issues continue to sprout, and I'll be honest, part of me also—I've been in situations where “never events” should never have occurred.” — Veteran transplant administrator/executive at Massachusetts General Hospital", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:05+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a977-9b58501a1abd", "parentComponentId": null }, { "bbox": { "h": 0.02, "w": 0.25, "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:15.162+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "4e602e76-3575-4497-bd57-56cc7c73ac5d", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [], "arcBeats": [], "loops": [], "locked": true }, { "page": 92, "type": "tension", "title": "The slide uses a Q&A format to highlight alleged wasteful practices (flying multiple planes) and the need for manual intervention to correct them.", "function": "expose_contradiction", "rawType": "expose_contradiction", "block": null, "metadata": { "slideType": "expose_contradiction", "slideTypeCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-124c-75aa-984a-0a3d0d8fc8df", "version": 1, "description": null }, "function": "expose_contradiction", "functionCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-171f-776f-887c-73edaff4cf9c", "version": 1, "description": null }, "density": "dense", "densityScore": 50, "componentCount": 5, "textChars": 3573, "nDataPoints": 0, "notes": "The slide uses a Q&A format to highlight alleged wasteful practices (flying multiple planes) and the need for manual intervention to correct them.", "elementsJson": [ "paragraph", "quote_block", "footnote" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:12:15.313+00", "seconds": 4.193, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/92", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-92", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "The “Never Events” which MGH stated occur with weekly regularity refer to the practice of allegedly flying in multiple jets for a single organ recovery, a recurring theme in our transplant center interviews – “a free check to drive up the cost...any time that two planes fly in...I mean, this just happened the other day...indiscriminate use just to drive up utilization.”", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:05+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a978-ab7a9d314212", "parentComponentId": null }, { "bbox": { "h": 0.35, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "paragraph", "text": "The \"Never Events\" which MGH stated occur with weekly regularity refer to the practice of allegedly flying in multiple jets for a single organ recovery, a recurring theme in our transplant center interviews – \"a free check to drive up the cost...any time that two planes fly in...I mean, this just happened the other day...indiscriminate use just to drive up utilization.\" The executive detailed an organ recovery in Denver, as an example, where TransMedics attempted to route and send multiple planes in a way that \"was just weird\" – \"I literally had to walk through with the coordinator, no, that doesn't make any sense...try again...I got a phone call in fifteen minutes, and they gave me the actual option that should have happened...that's a lot more economical.\"", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:15.313+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "897ce363-0fcc-4cbe-a4b6-c0a1c871a2fa", "parentComponentId": null }, { "bbox": { "h": 0.45, "w": 0.86, "x": 0.07, "y": 0.45 }, "kind": "quote", "text": "\"Never events\" like flying in multiple planes indiscriminately Q: \"So, what is happening once or twice a week? Are they trying to run circles around you? What are they doing exactly? And then I want to talk about the never events you mentioned and not reporting stuff to the FDA.\" A: \"It runs the gamut of just having a free check to drive up the cost, having indiscriminate financial stewardship of the resources that are being used...it's really just indiscriminate use just to drive up the utilization, which happens - now any time that two planes fly in I mean, this just happened the other day. Two planes...it was a pair of lungs coming over from Denver, and it had just been a plane that took the team out and came back with the organ or put it on the pump, and it would be an unmanned, one-way organ over to Boston and that would have been it. But instead, they had to take one plane from Dallas, and the other interesting thing is the Dallas plane over to Denver, and there was another procurement team that's coming from nearby that needed to be flown out. And then the other team had to come back to Dallas. It was just weird, hey, we're going to be doing this...I literally had to walk through with the coordinator; no, that doesn't make any sense; try again. Call me back in fifteen minutes, and you can give me a couple more options. What ended up happening is I got a phone call in fifteen minutes, and they gave me the actual option that should have happened, which was to take a plane, go to Denver, fly it back, and then we'll fly the rest of the crew back on a commercial jet. That's a lot more economical.\" – Veteran transplant administrator/executive at Massachusetts General Hospital", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:15.313+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "090eccf1-7f43-41b8-9c2f-6934235de693", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "“It runs the gamut of just having a free check to drive up the cost, having indiscriminate financial stewardship of the resources that are being used...it’s really just indiscriminate use just to drive up the utilization...It was just weird...I literally had to walk through with the coordinator; no, that doesn’t make any sense; try again...I got a phone call in fifteen minutes, and they gave me the actual option that should have happened, which was to take a plane, go to Denver, fly it back, and then we’ll fly the rest of the crew back on a commercial jet. That’s a lot more economical.” — Veteran transplant administrator/executive at Massachusetts General Hospital", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:05+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a978-afafee33d523", "parentComponentId": null }, { "bbox": { "h": 0.02, "w": 0.3, "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:15.313+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "973fa93a-9b88-4c95-a2b7-7e3e9b4f4ea1", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [], "arcBeats": [], "loops": [], "locked": true }, { "page": 93, "type": "tension", "title": "The slide uses a Q&A format to present a customer testimonial, highlighting specific phrases like 'roundabout answers' and 'used car salesman'.", "function": "expose_contradiction", "rawType": "testimonial", "block": null, "metadata": { "slideType": "testimonial", "slideTypeCanon": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52d-0a2d-7782-8a48-7e84df92cc97", "version": 1, "description": null }, "function": "expose_contradiction", "functionCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-171f-776f-887c-73edaff4cf9c", "version": 1, "description": null }, "density": "balanced", "densityScore": 48, "componentCount": 5, "textChars": 2576, "nDataPoints": 0, "notes": "The slide uses a Q&A format to present a customer testimonial, highlighting specific phrases like 'roundabout answers' and 'used car salesman'.", "elementsJson": [ "paragraph", "quote_block", "footnote" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:12:15.223+00", "seconds": 3.772, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/93", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-93", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "Racketeering strikes us an appropriate term given the conduct MGH described – a label another customer used directly: “when you ask questions...you get a bunch of roundabout answers...oh sorry, we mixed up that time zone because it was central times versus eastern time.”", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:06+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a978-f4a9ddc791e2", "parentComponentId": null }, { "bbox": { "h": 0.55, "w": 0.86, "x": 0.07, "y": 0.35 }, "kind": "paragraph", "text": "“Roundabout answers” and acting like a “used car salesman”\nQ: “Do they even give you transparency as to where the planes are coming from, who’s on them, and what the invoices are? I’m hearing that they don’t provide that information even when asked. Somebody used the phrase mystery fees.”\nA: “Not only that of the mystery, when you ask questions to them, you get the answer then, and then you get a bunch of roundabout answers down the line: Oh, sorry, we mixed up that time zone because it was central time versus eastern time. And I’m like, guys, we’re professionals here. This is what you’re being paid to do. If you mix up the time zones, I don’t know. I’m literally at odds and on top of that, here I am doing your job for you. Again, it just gets to a point where it’s a big point of frustration…it’s their team that racks up the price because depending on the size of the jet, depending on if you’re going to bring the surgeons on or not, if it’s just a module or not, and you have all these added fees like a used car salesman saying, oh, by the way, you can this and get it financed at zero percent but then there are all these other things that can just be added on, and it’s not what we signed up for, nor is it what we need.” – Veteran transplant administrator/executive at Massachusetts General Hospital", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:15.223+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "919e649b-53e3-4329-ba0b-4fb55d8ba7b8", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "“when you ask questions...you get a bunch of roundabout answers...oh sorry, we mixed up that time zone because it was central times versus eastern time.” ... “if you mix up the time zones, I don’t know...it’s their team that racks up the price...all these added fees like a used car salesman...it’s not what we signed up for, nor is it what we need.” — Veteran transplant administrator/executive at Massachusetts General Hospital", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:06+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a978-f88dc8267444", "parentComponentId": null }, { "bbox": { "h": 0.03, "w": 0.3, "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:15.223+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "a3f65d20-ef39-4587-baf5-934e8bd0b021", "parentComponentId": null }, { "bbox": { "h": 0.25, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "title", "text": "Racketeering strikes us an appropriate term given the conduct MGH described – a label another customer used directly: “when you ask questions…you get a bunch of roundabout answers…oh sorry, we mixed up that time zone because it was central times versus eastern time.” MGH naturally expressed incredulity and dismay – “if you mix up the time zones, I don’t know…it’s their team that racks up the price…all these added fees like a used car salesman…it’s not what we signed up for, nor is it what we need.”", "attrs": null, "canon": { "kind": { "name": "Title", "slug": "title", "status": "active", "canonId": "019de52c-f7dd-76d9-b848-b1f12bd85cf4", "version": 1, "description": "Slide title or headline." }, "tool": null, "subkind": { "name": "Headline", "slug": "headline", "status": "active", "canonId": "019de52c-fae1-7463-9a7c-d60668eced0d", "version": 1, "description": null }, "framework": null }, "subkind": "headline", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:15.223+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "01ab3d0d-0c0f-4848-a223-bd772105ba1a", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [], "arcBeats": [], "loops": [], "locked": true }, { "page": 94, "type": "tension", "title": "The slide uses direct quotes from industry experts to build a case against the subject company's business practices.", "function": "expose_contradiction", "rawType": "expose_contradiction", "block": null, "metadata": { "slideType": "expose_contradiction", "slideTypeCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-124c-75aa-984a-0a3d0d8fc8df", "version": 1, "description": null }, "function": "expose_contradiction", "functionCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-171f-776f-887c-73edaff4cf9c", "version": 1, "description": null }, "density": "dense", "densityScore": 52, "componentCount": 6, "textChars": 2202, "nDataPoints": 0, "notes": "The slide uses direct quotes from industry experts to build a case against the subject company's business practices.", "elementsJson": [ "paragraph", "callout_box", "footnote" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:12:14.733+00", "seconds": 3.14, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/94", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-94", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "Every major transplant center we interviewed conveyed what appear to be racketeering-type tactics.", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:05+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a977-c4db37fa9926", "parentComponentId": null }, { "bbox": { "h": 0.25, "w": 0.86, "x": 0.07, "y": 0.44 }, "kind": "list", "text": "Allegedly won’t provide air transport pricing ahead of time; “hard to pin them down”\nA: “There’s so much variability in the flights...they jack the prices up like crazy...they do not commit to a price on their air travel. It is very hard to pin them down...they’re not going to tell you that amount of detail.”\nQ: “They don’t want you to be able to comparison shop with air travel.”\nA: “That’s right.”\nQ: “So, you’ve tried getting pricing from them for the air travel and they won’t tell you?”\nA: “Right.” - Transplant surgeon at a high-volume academic center", "attrs": null, "canon": { "kind": { "name": "List", "slug": "list", "status": "active", "canonId": "019de52c-f94b-779b-a53b-fd4904a5f4d2", "version": 1, "description": "Bullet or numbered list." }, "tool": null, "subkind": { "name": "Bullet list", "slug": "bullet", "status": "active", "canonId": "019de52c-fc98-7169-a083-5cab805076ca", "version": 1, "description": null }, "framework": null }, "subkind": "bullet", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:14.733+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "5934bec7-1a01-4fb0-b8e5-b548d41e0b3b", "parentComponentId": null }, { "bbox": { "h": 0.15, "w": 0.86, "x": 0.07, "y": 0.72 }, "kind": "list", "text": "Cedars-Sinai: lack of transparency and surprising charges for air transport\n“I mean, we have had extra cost for transportation and we’re like, “What is this?” And we hear, “Oh, the surgeon didn’t come with the perfusion team. The surgeon came from Dallas, so we had to send him back to Dallas.” I’ve gotten bills like that.” – Transplant surgeon", "attrs": null, "canon": { "kind": { "name": "List", "slug": "list", "status": "active", "canonId": "019de52c-f94b-779b-a53b-fd4904a5f4d2", "version": 1, "description": "Bullet or numbered list." }, "tool": null, "subkind": { "name": "Bullet list", "slug": "bullet", "status": "active", "canonId": "019de52c-fc98-7169-a083-5cab805076ca", "version": 1, "description": null }, "framework": null }, "subkind": "bullet", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:14.733+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "b33089ea-75a4-4c7d-8aeb-d4ad2ed0989e", "parentComponentId": null }, { "bbox": { "h": 0.35, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "paragraph", "text": "Every major transplant center we interviewed conveyed what appear to be racketeering-type tactics. A major center, whose experience we already covered and who referred to TransMedics conduct as “mafia-style” and “thug-style,” described the modus operandi on air transport overcharges: “they jack up the prices like crazy...there’s a lot of variability...and they do not commit to a price on their air travel...it is very hard to pin them down.” Cedars-Sinai in Los Angeles, another high volume user, indicated shock after getting charged for multiple flights for a single organ recovery: “we have had extra cost for transportation and we’re like, ‘what is this?...and we hear, ‘oh, the surgeon didn’t come with the perfusion team...I’ve gotten bills like that.”", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:14.733+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "3bb73670-534e-4c76-b72e-0cf84646f090", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "\"There’s so much variability in the flights, it depends on aircraft, it depends on. If the Kentucky Derby is going on, you can’t find a plan anywhere, and they jack the prices up like crazy. There’s really a lot of variability in air travel and they do not commit to a price on their air travel. It is very hard to pin them down\" — Transplant surgeon at a high-volume academic center", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:05+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a977-c998b66f5ac7", "parentComponentId": null }, { "bbox": { "h": 0.02, "w": 0.3, "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:14.733+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "0737e25c-e710-4301-84e1-e6171ec45f0a", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [ { "matchId": "7879ed16-87cb-4273-acae-d44509052516", "evidence": "The slide explicitly frames the company's actions as 'racketeering-type tactics' and 'mafia-style' to expose potential misconduct.", "framework": null, "confidence": 0.9, "extraction": { "at": "2026-05-02 20:12:14.733+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 94, "frameworkName": "fraud-exposure" } ], "arcBeats": [], "loops": [], "locked": true }, { "page": 95, "type": "tension", "title": "The slide uses a Q&A transcript format to substantiate claims of unnecessary high-cost air travel for short-distance organ procurement.", "function": "expose_contradiction", "rawType": "expose_contradiction", "block": null, "metadata": { "slideType": "expose_contradiction", "slideTypeCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-124c-75aa-984a-0a3d0d8fc8df", "version": 1, "description": null }, "function": "expose_contradiction", "functionCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-171f-776f-887c-73edaff4cf9c", "version": 1, "description": null }, "density": "dense", "densityScore": 50, "componentCount": 5, "textChars": 1959, "nDataPoints": 4, "notes": "The slide uses a Q&A transcript format to substantiate claims of unnecessary high-cost air travel for short-distance organ procurement.", "elementsJson": [ "paragraph", "quote_block" ], "confidence": 0.95, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:12:15.153+00", "seconds": 3.247, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/95", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-95", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "one could accurately describe it as an orgy of billing fraud.", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:08+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a97a-598900314c40", "parentComponentId": null }, { "bbox": { "h": 0.45, "w": 0.86, "x": 0.07, "y": 0.44 }, "kind": "list", "text": "Charging $120,000 to $150,000 for air transport when donor and recipient are within driving distance\nA: “Depending on where the flight is and stuff like that - it’s anywhere between $120,000 and 150,000.”\nQ: “The livers that they’re procuring for you, how far away are they coming from typically - within the region?”\nA: “Most of the time, they’re within the region because that’s what we’re being offered. The new liver allocation is getting ready to start, and we’re going to start seeing national sharing, but livers are still within the 250 nautical miles. We don’t really get offered anything of significance, say, from New Jersey.”\nQ: “The 10 times you’ve used them recently, it’s all been within 250 miles?”\nA: “Yeah, pretty much.”\nQ: “They’re using their air transport to make it quicker? Or are they using a van or something? It’s kind of within the four-hour distance, driving distance.”\nA: “No, it’s all air because you want to get the organs back quickly.” – Transplant surgeon, Utah center", "attrs": null, "canon": { "kind": { "name": "List", "slug": "list", "status": "active", "canonId": "019de52c-f94b-779b-a53b-fd4904a5f4d2", "version": 1, "description": "Bullet or numbered list." }, "tool": null, "subkind": { "name": "Bullet list", "slug": "bullet", "status": "active", "canonId": "019de52c-fc98-7169-a083-5cab805076ca", "version": 1, "description": null }, "framework": null }, "subkind": "bullet", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:15.153+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "9a44cf35-6038-48c0-96b2-556989f5d26d", "parentComponentId": null }, { "bbox": { "h": 0.35, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "paragraph", "text": "The University of Utah is a high-volume user of TransMedics device, and not only are its air transport charges as egregious as UCSF, Mass General, UCSD, and other centers but it illustrates the extreme level to which TransMedics has pushed its scheme – one could accurately describe it as an orgy of billing fraud. A transplant surgeon affiliated with the University of Utah stated they pay a mind-boggling $120,000 to $150,000 in air transport charges per case. But here’s the rub: he indicated that basically 100% of these cases involved a donor and recipient within a driving radius of 250 miles – in other words, they are paying six-figure transport charges to fly in TransMedics jets when a van would suffice with perhaps a $3,000 cost.", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:15.153+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "b9211475-34b6-498f-96d3-d7ee702ad43b", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "No, it’s all air because you want to get the organs back quickly. — Transplant surgeon, Utah center", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:08+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a97a-5c424a3714b4", "parentComponentId": null }, { "bbox": { "h": 0.02, "w": 0.25, "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:15.153+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "1f994fb8-c622-458d-94d6-11c445a4bf04", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [ { "matchId": "b4b31a1a-ddf0-4252-a181-db9b56c36df5", "evidence": "The slide explicitly frames the business practice as 'billing fraud' and uses expert testimony to contrast high costs with low-cost alternatives.", "framework": null, "confidence": 0.9, "extraction": { "at": "2026-05-02 20:12:15.153+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 95, "frameworkName": "fraud-exposure" } ], "arcBeats": [], "loops": [], "locked": true }, { "page": 96, "type": "tension", "title": "The slide uses a Q&A format to expose a potential business practice contradiction.", "function": "expose_contradiction", "rawType": "expose_contradiction", "block": null, "metadata": { "slideType": "expose_contradiction", "slideTypeCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-124c-75aa-984a-0a3d0d8fc8df", "version": 1, "description": null }, "function": "expose_contradiction", "functionCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-171f-776f-887c-73edaff4cf9c", "version": 1, "description": null }, "density": "balanced", "densityScore": 40, "componentCount": 5, "textChars": 1213, "nDataPoints": 1, "notes": "The slide uses a Q&A format to expose a potential business practice contradiction.", "elementsJson": [ "paragraph", "quote_block", "footnote" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:12:15.234+00", "seconds": 3.305, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/96", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-96", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "The details the Utah surgeon shared are shocking – that TransMedics allegedly bills them for multiple private jets even both the donor and recipient are both “just down the street from us” in Salt Lake City.", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:05+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a978-7640f92d886f", "parentComponentId": null }, { "bbox": { "h": 0.15, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "paragraph", "text": "When we asked the surgeon why they pay up to $150,000 for air transport when the organ recovery is within the standard 4-hour driving range, his answer was telling and betrays the heart of the scheme - \"it’s all air because you want to get the organs back quickly.\"", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:15.234+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "24e3531d-7c78-4bf4-8a6b-3e6cf2e65a17", "parentComponentId": null }, { "bbox": { "h": 0.35, "w": 0.86, "x": 0.07, "y": 0.55 }, "kind": "quote", "text": "Flying in multiple planes even when the donor and recipient are in the same city. Q: \"Do they do flights even if it's an hour's drive or something?\" A: \"I feel like they fly for almost everything...\"", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:15.234+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "be5f8105-f998-4a65-981f-4783788a5c23", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "“I feel like they fly for almost everything, but most of the time, the surgeon is not local, and the perfusionist isn't local, and that may be something that we’re trying to change for us where if the donor’s just down the street from us but you have to bring in a surgeon from California to do the donor and the perfusionist is from wherever, that’s what seems to happen....since they’ve gotten their own jets, everybody just flies in their own jets.” — Transplant surgeon, Utah center", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:05+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a978-7a592dffbf43", "parentComponentId": null }, { "bbox": { "h": 0.02, "w": 0.3, "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:15.234+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "4c41975a-7788-4902-91b9-3682f5c68175", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [ { "matchId": "233500d0-e205-4aba-bdbd-4044a7f8c098", "evidence": "The slide explicitly frames the company's billing practices as a 'scheme' and uses expert testimony to contradict the stated value proposition.", "framework": null, "confidence": 0.9, "extraction": { "at": "2026-05-02 20:12:15.234+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 96, "frameworkName": "fraud-exposure" } ], "arcBeats": [], "loops": [], "locked": true }, { "page": 97, "type": "tension", "title": "The slide uses a quote to frame a potential conflict of interest or perverse incentive structure in organ transport.", "function": "expose_contradiction", "rawType": "quote_slide", "block": null, "metadata": { "slideType": "quote_slide", "slideTypeCanon": { "name": "Quote slide", "slug": "quote_slide", "status": "active", "canonId": "019de52d-098e-7555-a9fd-4f0af7e80bc2", "version": 1, "description": null }, "function": "expose_contradiction", "functionCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-171f-776f-887c-73edaff4cf9c", "version": 1, "description": null }, "density": "balanced", "densityScore": 41, "componentCount": 6, "textChars": 1208, "nDataPoints": 0, "notes": "The slide uses a quote to frame a potential conflict of interest or perverse incentive structure in organ transport.", "elementsJson": [ "paragraph", "quote_block", "footnote" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:12:17.612+00", "seconds": 5.646, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/97", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-97", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": { "h": 0.03, "w": 0.45, "x": 0.07, "y": 0.31 }, "kind": "callout", "text": "Transplant surgeon doesn't care about cost, only transplant volumes", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": null, "subkind": { "name": "Primary callout", "slug": "primary", "status": "active", "canonId": "019de52c-fbd1-70eb-a9ce-8997f8674c1d", "version": 1, "description": null }, "framework": null }, "subkind": "primary", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:17.612+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "1b6f99ae-95f8-4f8c-b4e7-2f9d4411a709", "parentComponentId": null }, { "bbox": null, "kind": "callout", "text": "the metrics I’m held to, as a transplant surgeon, are the number of liver transplants I do...so, I don’t really care about cost.", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:05+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a977-ac15ff9eafe7", "parentComponentId": null }, { "bbox": { "h": 0.22, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "paragraph", "text": "As a preview of a later section on what we believe to be an organ trafficking scheme in exchange for device volumes, we note a particularly chilling comment by the surgeon, when we asked how he feels about being hats charged stratospheric amounts for private jet transport when the organ could easily have been recovered by car: “the metrics I’m held to as a transplant surgeon are the number of liver transplants I do...so, I don’t really care about cost.”", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:17.612+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "078024b8-3a74-4c1f-8dd3-90c960395fef", "parentComponentId": null }, { "bbox": { "h": 0.08, "w": 0.86, "x": 0.07, "y": 0.34 }, "kind": "quote", "text": "Q: “How does it make you feel that to be charged $50,000 just to fly a perfusionist and get utilization on a $13 million plane?”\nA: “I think it’s highly expensive, but the metrics that I’m held to, as a transplant surgeon, are the number of liver transplants I do...so, I don’t really care about cost.” – Transplant surgeon, Utah center", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:17.612+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "35ae2c39-d30e-47ba-91a8-3c61dd9b3652", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "“the metrics I’m held to, as a transplant surgeon, are the number of liver transplants I do...so, I don’t really care about cost.” — Transplant surgeon, Utah center", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:05+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a977-b1b56ba5b350", "parentComponentId": null }, { "bbox": { "h": 0.02, "w": 0.25, "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:17.612+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "e7bb4c03-b442-442c-8ab3-5dcb9a6966c0", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [], "arcBeats": [], "loops": [], "locked": true }, { "page": 98, "type": "tension", "title": "This is a highly inflammatory slide accusing the company of illegal kickbacks and unethical business practices.", "function": "name_villain", "rawType": "villain_critique", "block": null, "metadata": { "slideType": "villain_critique", "slideTypeCanon": { "name": "Villain critique", "slug": "villain_critique", "status": "active", "canonId": "019de52d-10bc-7136-bf20-09de59d17447", "version": 1, "description": null }, "function": "name_villain", "functionCanon": { "name": "Name villain", "slug": "name_villain", "status": "active", "canonId": "019de52d-1746-70d6-bc58-5eeaf5865526", "version": 1, "description": null }, "density": "sparse", "densityScore": 9, "componentCount": 2, "textChars": 388, "nDataPoints": 0, "notes": "This is a highly inflammatory slide accusing the company of illegal kickbacks and unethical business practices.", "elementsJson": [ "paragraph" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:12:15.044+00", "seconds": 3.074, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/98", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-98", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "Part 3. Revenue is dependent on a handful of transplant surgeons/centers - \"prostitutes\" who are \"completely owned and operated by TransMedics\" - who allegedly receive kickbacks and inducements.", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:05+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a977-f3b28b8e767d", "parentComponentId": null }, { "bbox": { "h": 0.15, "w": 0.854, "x": 0.073, "y": 0.07 }, "kind": "title", "text": "Part 3. Revenue is dependent on a handful of transplant surgeons/centers - \"prostitutes\" who are \"completely owned and operated by TransMedics\" - who allegedly receive kickbacks and inducements.", "attrs": null, "canon": { "kind": { "name": "Title", "slug": "title", "status": "active", "canonId": "019de52c-f7dd-76d9-b848-b1f12bd85cf4", "version": 1, "description": "Slide title or headline." }, "tool": null, "subkind": { "name": "Headline", "slug": "headline", "status": "active", "canonId": "019de52c-fae1-7463-9a7c-d60668eced0d", "version": 1, "description": null }, "framework": null }, "subkind": "headline", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:15.044+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "e3f3d4c6-d0d1-4262-8ff6-b438cd6a2de3", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [], "arcBeats": [], "loops": [], "locked": true }, { "page": 99, "type": "tension", "title": "This is a short-seller research note slide containing allegations of fraud and unethical business practices.", "function": "name_villain", "rawType": "villain_critique", "block": null, "metadata": { "slideType": "villain_critique", "slideTypeCanon": { "name": "Villain critique", "slug": "villain_critique", "status": "active", "canonId": "019de52d-10bc-7136-bf20-09de59d17447", "version": 1, "description": null }, "function": "name_villain", "functionCanon": { "name": "Name villain", "slug": "name_villain", "status": "active", "canonId": "019de52d-1746-70d6-bc58-5eeaf5865526", "version": 1, "description": null }, "density": "dense", "densityScore": 52, "componentCount": 6, "textChars": 2363, "nDataPoints": 0, "notes": "This is a short-seller research note slide containing allegations of fraud and unethical business practices.", "elementsJson": [ "paragraph", "quote_block", "footnote" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:12:19.316+00", "seconds": 7.115, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/99", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-99", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": { "h": 0.02, "w": 0.35, "x": 0.07, "y": 0.45 }, "kind": "callout", "text": "Dependent on surgeons who are allegedly questionable", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": null, "subkind": { "name": "Primary callout", "slug": "primary", "status": "active", "canonId": "019de52c-fbd1-70eb-a9ce-8997f8674c1d", "version": 1, "description": null }, "framework": null }, "subkind": "primary", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:19.316+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "69a07744-3055-413e-bf8a-864cbcb3a83b", "parentComponentId": null }, { "bbox": null, "kind": "callout", "text": "He does. He has his paid - the biggest whore in my field in cardiac surgery was a guy named Abbas Ardehali at UCLA who was going around telling everybody that every heart should be put on the OCS system.", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:05+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a978-331c933bd5e1", "parentComponentId": null }, { "bbox": { "h": 0.35, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "paragraph", "text": "TransMedics revenue - and growth to date - is dependent on a handful of dubious physicians and centers, often of the same Egyptian or Middle East descent as the CEO and members of the leadership team – allegedly “prostitutes” who are “completely owned and operated by TransMedics,” according to other surgeons we interviewed. We believe these high-volume OCS users a) receive what we think are inducements and kickbacks via stock, lavish travel, and other means; and b) we think that they are beneficiaries of high-risk organs that reputable surgeons won’t touch, which we believe to be improperly steered their way as part of a quid pro quo that they arrive on an OCS pump; and c) that they achieve these unusual volumes via vast off-label usage. A surgeon who runs a leading West Coast academic transplant center described a dynamic we see in almost every medtech or biotech fraud we short, when we asked if the CEO has a “little inner circle”: “He does...Waleed’s got people like that, that will stick by him because they’re conflicted...they’re making a lot of money consulting and speaking.”", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:19.316+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "d101e958-59d6-4713-b145-f3a535103274", "parentComponentId": null }, { "bbox": { "h": 0.35, "w": 0.86, "x": 0.07, "y": 0.52 }, "kind": "quote", "text": "He does. He has his paid - the biggest whore in my field in cardiac surgery was a guy named Abbas Ardehali at UCLA who was going around telling everybody that every heart should be put on the OCS system... That’s an example of someone who’s completely owned and operated by TransMedics... Waleed’s got people like that, that will stick by him because they’re conflicted. They’re making a lot of money consulting and speaking. But the vast majority of surgeons in the field are not wedded to him and are in other trials right now.", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:19.316+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "87cc4204-a7cf-4f9e-bef4-46e04bdab9a5", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "“He does. He has his paid - the biggest whore in my field in cardiac surgery was a guy named Abbas Ardehali at UCLA who was going around telling everybody that every heart should be put on the OCS system... He’s got his box of golden PowerPoint slides, travels around the world, and probably makes $100,000 per year in consulting fees.” — Prominent transplant surgeon, leadership role at a West Coast academic transplant center", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:05+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a978-36f2cad19807", "parentComponentId": null }, { "bbox": { "h": 0.02, "w": 0.3, "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:19.316+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "f4d72508-28ef-4a56-be06-5d6a281ab044", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [ { "matchId": "05c606e2-62da-45d8-8bec-7992a36af345", "evidence": "The slide explicitly frames the company's business model as a 'medtech or biotech fraud' and uses investigative techniques to expose alleged conflicts of interest.", "framework": null, "confidence": 0.9, "extraction": { "at": "2026-05-02 20:12:19.316+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 99, "frameworkName": "fraud-exposure" } ], "arcBeats": [], "loops": [], "locked": true }, { "page": 100, "type": "tension", "title": "The slide uses a combination of narrative text and visual evidence (social media posts) to discredit the subject.", "function": "name_villain", "rawType": "villain_critique", "block": null, "metadata": { "slideType": "villain_critique", "slideTypeCanon": { "name": "Villain critique", "slug": "villain_critique", "status": "active", "canonId": "019de52d-10bc-7136-bf20-09de59d17447", "version": 1, "description": null }, "function": "name_villain", "functionCanon": { "name": "Name villain", "slug": "name_villain", "status": "active", "canonId": "019de52d-1746-70d6-bc58-5eeaf5865526", "version": 1, "description": null }, "density": "dense", "densityScore": 59, "componentCount": 7, "textChars": 1916, "nDataPoints": 0, "notes": "The slide uses a combination of narrative text and visual evidence (social media posts) to discredit the subject.", "elementsJson": [ "paragraph", "photo", "footnote" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:12:19.356+00", "seconds": 7.042, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/100", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-100", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "Ardehali is a self-promotional, LA-based “celebrity surgeon” who gives TED talks with claims about the OCS pump that we view as false, reckless, or quackery", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:05+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a978-8e3b4cf046de", "parentComponentId": null }, { "bbox": { "h": 0.35, "w": 0.42, "x": 0.07, "y": 0.55 }, "kind": "image", "text": null, "attrs": null, "canon": { "kind": { "name": "Image", "slug": "image", "status": "active", "canonId": "019de52c-f978-701f-a720-51d029d769e7", "version": 1, "description": "Photo, illustration, screenshot or icon." }, "tool": null, "subkind": { "name": "Illustration", "slug": "illustration", "status": "active", "canonId": "019de52c-fe76-7772-a5ac-c0b7294d7615", "version": 1, "description": null }, "framework": null }, "subkind": "illustration", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:19.356+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "3c52b9cd-547f-4fc7-8cc2-50507873004c", "parentComponentId": null }, { "bbox": { "h": 0.35, "w": 0.41, "x": 0.52, "y": 0.55 }, "kind": "image", "text": null, "attrs": null, "canon": { "kind": { "name": "Image", "slug": "image", "status": "active", "canonId": "019de52c-f978-701f-a720-51d029d769e7", "version": 1, "description": "Photo, illustration, screenshot or icon." }, "tool": null, "subkind": { "name": "Photo", "slug": "photo", "status": "active", "canonId": "019de52c-fd37-757f-b4a8-ca26d4888875", "version": 1, "description": null }, "framework": null }, "subkind": "photo", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:19.356+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "79d5917d-b0fa-4da4-827e-60cb807105f5", "parentComponentId": null }, { "bbox": { "h": 0.45, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "paragraph", "text": "The suspect surgeons in transplant surgery appear to be well-known, as it is a small field. In the previous quote, the transplant chief stated that the “biggest whore is my field in cardiac surgery was a guy named Abbas Ardehali” who allegedly “was going around telling everybody that every heart should be put on the OCS system...that’s an example of someone who’s completely owned and operated by TransMedics.” Ardehali is a self-promotional, LA-based “celebrity surgeon” who gives TED talks with claims about the OCS pump that we view as false, reckless, or quackery – “he is developing something called the...”heart in a box” for TransMedics...as the principal investigator, he is quite enthusiastic.” He even sports his own Wikipedia entry, presumably self-written – “a pioneer in the field...constantly pushing the boundaries of what is possible,” who has been interviewed by ABC News, CNN, Fox News, NBC News, Al Jazeera, and others.", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:19.356+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "94d45558-11c3-46cd-8493-9d466636e0a9", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "“biggest whore is my field in cardiac surgery was a guy named Abbas Ardehali” — Anonymous transplant chief; “was going around telling everybody that every heart should be put on the OCS system...that’s an example of someone who’s completely owned and operated by TransMedics.” — Anonymous transplant chief; “a pioneer in the field...constantly pushing the boundaries of what is possible,” — Wikipedia entry for Dr. Ardehali", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:05+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a978-93f366c1a52e", "parentComponentId": null }, { "bbox": { "h": 0.05, "w": 0.75, "x": 0.07, "y": 0.92 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts; https://www.laweekly.com/abbas-ardehali-l-a-transplant/; https://www.instagram.com/p/ChFh3k-pORX/?igsh=MWNvVNW9iZTBxdDF0eQ==; https://images.app.goo.gl/jTHWTHijGx9kJ7PQA; https://www.ted.com/talks/abbas_ardehali_the_miracle_of_organ_donation_and_a_breakthrough_for_the_future/transcript?subtitle=en", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:19.356+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "4355db36-d919-4e0d-8a13-bb2af3c23b12", "parentComponentId": null }, { "bbox": { "h": 0.03, "w": 0.35, "x": 0.07, "y": 0.51 }, "kind": "title", "text": "Social media posts featuring Dr. Ardehali", "attrs": null, "canon": { "kind": { "name": "Title", "slug": "title", "status": "active", "canonId": "019de52c-f7dd-76d9-b848-b1f12bd85cf4", "version": 1, "description": "Slide title or headline." }, "tool": null, "subkind": { "name": "Subtitle", "slug": "subtitle", "status": "active", "canonId": "019de52c-fb09-739d-900c-815b0d9ac526", "version": 1, "description": null }, "framework": null }, "subkind": "subtitle", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:19.356+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "1cc61906-cdde-4c5b-b14b-307859c41ef9", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [], "arcBeats": [], "loops": [], "locked": true }, { "page": 101, "type": "tension", "title": "The slide uses a skeptical tone to challenge the scientific validity of the claims presented in the video.", "function": "expose_contradiction", "rawType": "villain_critique", "block": null, "metadata": { "slideType": "villain_critique", "slideTypeCanon": { "name": "Villain critique", "slug": "villain_critique", "status": "active", "canonId": "019de52d-10bc-7136-bf20-09de59d17447", "version": 1, "description": null }, "function": "expose_contradiction", "functionCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-171f-776f-887c-73edaff4cf9c", "version": 1, "description": null }, "density": "balanced", "densityScore": 46, "componentCount": 6, "textChars": 1496, "nDataPoints": 0, "notes": "The slide uses a skeptical tone to challenge the scientific validity of the claims presented in the video.", "elementsJson": [ "paragraph", "photo" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:12:16.229+00", "seconds": 3.882, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/101", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-101", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "The claims for machine perfusion become increasingly preposterous: “we can convert different blood types to an O blood type...we can actually make changes in the genetic makeup of the donor organ...we can add genes...silence genes...those foreign proteins that were the cause of rejection.”", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:05+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a978-dc70b8f58c9a", "parentComponentId": null }, { "bbox": { "h": 0.45, "w": 0.86, "x": 0.07, "y": 0.48 }, "kind": "image", "text": null, "attrs": null, "canon": { "kind": { "name": "Image", "slug": "image", "status": "active", "canonId": "019de52c-f978-701f-a720-51d029d769e7", "version": 1, "description": "Photo, illustration, screenshot or icon." }, "tool": null, "subkind": { "name": "Photo", "slug": "photo", "status": "active", "canonId": "019de52c-fd37-757f-b4a8-ca26d4888875", "version": 1, "description": null }, "framework": null }, "subkind": "photo", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:16.229+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "c0b4eec2-ab22-42e3-af4e-d0c56d208b2d", "parentComponentId": null }, { "bbox": { "h": 0.35, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "paragraph", "text": "In his TED talk, Ardehali suggests one can put pneumonia-infected lungs on the OCS pump which “can actually repair a donor organ” with supernormal doses of antibiotics that would cause “toxicities” in the donor – transplanting infected lungs strikes us a good way to lose one’s medical license and be sued out of business for malpractice. Moreover, we are curious how the TransMedics pump protects lung cells and tissue from doses so high that they would harm the rest of a donor’s body. The claims for machine perfusion become increasingly preposterous: “we can convert different blood types to an O blood type...we can actually make changes in the genetic makeup of the donor organ...we can add genes...silence genes...those foreign proteins that were the cause of rejection.”", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:16.229+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "06efd295-62f0-44b1-900d-a4a882c331c4", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "“we can convert different blood types to an O blood type...we can actually make changes in the genetic makeup of the donor organ...we can add genes...silence genes...those foreign proteins that were the cause of rejection.” — Dr. Abbas Ardehali", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:05+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a978-e2a70028de0a", "parentComponentId": null }, { "bbox": { "h": 0.02, "w": 0.25, "x": 0.07, "y": 0.44 }, "kind": "source-note", "text": "TED talk by Dr. Ardehali, Dec 2023 – video stills", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:16.229+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "d3f27f95-24dc-440a-8528-bf25177aa1be", "parentComponentId": null }, { "bbox": { "h": 0.02, "w": 0.65, "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: https://www.ted.com/talks/abbas_ardehali_the_miracle_of_organ_donation_and_a_breakthrough_for_the_future/transcript?subtitle=en", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:16.229+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "f96657fa-a4f9-4846-9330-bc5a2574d94b", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [], "arcBeats": [], "loops": [], "locked": true }, { "page": 102, "type": "tension", "title": "The slide uses a 'villain' framing to call out specific medical professionals, linking them to questionable practices and providing visual evidence (conference ", "function": "name_villain", "rawType": "villain_critique", "block": null, "metadata": { "slideType": "villain_critique", "slideTypeCanon": { "name": "Villain critique", "slug": "villain_critique", "status": "active", "canonId": "019de52d-10bc-7136-bf20-09de59d17447", "version": 1, "description": null }, "function": "name_villain", "functionCanon": { "name": "Name villain", "slug": "name_villain", "status": "active", "canonId": "019de52d-1746-70d6-bc58-5eeaf5865526", "version": 1, "description": null }, "density": "balanced", "densityScore": 47, "componentCount": 7, "textChars": 1077, "nDataPoints": 0, "notes": "The slide uses a 'villain' framing to call out specific medical professionals, linking them to questionable practices and providing visual evidence (conference flyer and video screenshot).", "elementsJson": [ "paragraph", "screenshot", "photo" ], "confidence": 0.95, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:12:20.813+00", "seconds": 8.325, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/102", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-102", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": { "h": 0.05, "w": 0.86, "x": 0.07, "y": 0.41 }, "kind": "callout", "text": "Drs. Ghobrial and Abouljoud; headline excerpted from 2021 article about the latter: World-renowned transplant surgeon named Arab American of the Year", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": null, "subkind": { "name": "Primary callout", "slug": "primary", "status": "active", "canonId": "019de52c-fbd1-70eb-a9ce-8997f8674c1d", "version": 1, "description": null }, "framework": null }, "subkind": "primary", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:20.813+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "48a7ab9b-5765-4096-811e-566c008fb20a", "parentComponentId": null }, { "bbox": null, "kind": "callout", "text": "Surgeons indicated the following are among the top users and repeatedly flagged them across our interviews as engaging in questionable practices: 1) Rafik “Mark” Ghobrial at Houston Methodist; 2) Marwan Abouljoud at Henry Ford in Detroit; and 3) Mayo Arizona.", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:05+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a978-c277f36476a6", "parentComponentId": null }, { "bbox": { "h": 0.4, "w": 0.35, "x": 0.07, "y": 0.5 }, "kind": "image", "text": "Conference flyer for Mark Ghobrial", "attrs": null, "canon": { "kind": { "name": "Image", "slug": "image", "status": "active", "canonId": "019de52c-f978-701f-a720-51d029d769e7", "version": 1, "description": "Photo, illustration, screenshot or icon." }, "tool": null, "subkind": { "name": "Infographic", "slug": "infographic", "status": "active", "canonId": "019de52c-fe26-750c-9d7d-9f34e21324e8", "version": 1, "description": null }, "framework": null }, "subkind": "infographic", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:20.813+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "24b7b6df-80a1-4cf6-8992-2499d219af8c", "parentComponentId": null }, { "bbox": { "h": 0.4, "w": 0.5, "x": 0.43, "y": 0.5 }, "kind": "image", "text": "Video screenshot of Marwan Abouljoud", "attrs": null, "canon": { "kind": { "name": "Image", "slug": "image", "status": "active", "canonId": "019de52c-f978-701f-a720-51d029d769e7", "version": 1, "description": "Photo, illustration, screenshot or icon." }, "tool": null, "subkind": { "name": "Screenshot", "slug": "screenshot", "status": "active", "canonId": "019de52c-fd87-7509-8391-3d79fb339379", "version": 1, "description": null }, "framework": null }, "subkind": "screenshot", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:20.813+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "0a80eba9-85d5-46d7-9288-62b4f8b468aa", "parentComponentId": null }, { "bbox": { "h": 0.25, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "paragraph", "text": "Surgeons indicated the following are among the top users and repeatedly flagged them across our interviews as engaging in questionable practices: 1) Rafik “Mark” Ghobrial at Houston Methodist; 2) Marwan Abouljoud at Henry Ford in Detroit; and 3) Mayo Arizona.", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:20.813+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "d998c4a5-5f36-4d12-89b7-959dae61b46c", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "World-renowned transplant surgeon named Arab American of the Year — Headline excerpted from 2021 article about the latter", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:05+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a978-c7f92d65a7ee", "parentComponentId": null }, { "bbox": { "h": 0.05, "w": 0.86, "x": 0.07, "y": 0.94 }, "kind": "source-note", "text": "Source: https://x.com/arab_organizers/status/1846887346358124852; https://www.pressandguide.com/2013/02/27/world-renowned-transplant-surgeon-named-arab-american-of-the-year/; https://www.youtube.com/watch?v=lkzdWY6JFV8.", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:20.813+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "1ce5d332-9064-48eb-a3b8-b9b0484b4161", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [], "arcBeats": [], "loops": [], "locked": true }, { "page": 103, "type": "tension", "title": "The slide uses expert testimony to build a case for high customer concentration and potential ethical/business risks.", "function": "expose_contradiction", "rawType": "villain_critique", "block": null, "metadata": { "slideType": "villain_critique", "slideTypeCanon": { "name": "Villain critique", "slug": "villain_critique", "status": "active", "canonId": "019de52d-10bc-7136-bf20-09de59d17447", "version": 1, "description": null }, "function": "expose_contradiction", "functionCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-171f-776f-887c-73edaff4cf9c", "version": 1, "description": null }, "density": "overcrowded", "densityScore": 80, "componentCount": 8, "textChars": 3662, "nDataPoints": 10, "notes": "The slide uses expert testimony to build a case for high customer concentration and potential ethical/business risks.", "elementsJson": [ "paragraph", "quote_block", "footnote" ], "confidence": 0.95, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:12:16.548+00", "seconds": 3.723, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/103", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-103", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "The customer concentration is striking when one adds the volumes from a just a few others, whose questionable practices we detail in other sections: UCSD, which we estimate does 100 TransMedics cases; University of Utah, which we suspect will do over 50; and a center run by another Lebanon-trained physician, who told us he’s on track for 50 OCS pumps in 2024; and one in LA using 50 – another 250 devices.", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:06+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a979-abe20d7193f3", "parentComponentId": null }, { "bbox": null, "kind": "metric", "text": "customer concentration: 25%", "attrs": null, "canon": { "kind": { "name": "Metric", "slug": "metric", "status": "active", "canonId": "019de52c-f923-73bf-8081-d0b1a8c5264d", "version": 1, "description": "Big-number or KPI value." }, "tool": { "name": "Quantification", "slug": "quantification", "status": "active", "bestFor": null, "canonId": "019dd9e1-47ab-72ce-a079-aab1f5299e88", "version": 1, "bodyDocId": null, "description": "Translating a claim into numbers, charts, or tables.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": "primary", "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:06+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a979-b22fdb5fb0bc", "parentComponentId": null }, { "bbox": { "h": 0.45, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "paragraph", "text": "One surgeon estimated that “those true religious zealots to Waleed represent 50% of the business.” Another prominent surgeon indicated that Ghobrial and Mayo alone may be 300 devices a year. We think Abouljoud does at least 100, for 400 total across these 3 users – roughly $34MM in product revenue using an average consumable cost of $85,000, and $60MM in total revenue using $150,000 inclusive of NOP fees, by our math, which implies that just 3 users are 15% of total LTM revenue of $400MM. The customer concentration is striking when one adds the volumes from a just a few others, whose questionable practices we detail in other sections: UCSD, which we estimate does 100 TransMedics cases; University of Utah, which we suspect will do over 50; and a center run by another Lebanon-trained physician, who told us he’s on track for 50 OCS pumps in 2024; and one in LA using 50 – another 250 devices. Using the same assumptions, these 4 comprise another $38MM in revenue – that is, an estimated 25% of total TMDX revenue from just 7 high-risk users.", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:16.548+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "d2ff338c-8ffc-44d7-bdaa-1c331ea94001", "parentComponentId": null }, { "bbox": { "h": 0.1, "w": 0.86, "x": 0.07, "y": 0.55 }, "kind": "quote", "text": "Half of TransMedics business may be dependent on “religious zealots to Waleed”\n“I would say that maybe those true religious zealots to Waleed represent 50% of the business.” - Prominent transplant surgeon, leadership role at a West Coast academic transplant center", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:16.548+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "252319b1-33b9-40da-bf1d-a5cd0d56c180", "parentComponentId": null }, { "bbox": { "h": 0.1, "w": 0.86, "x": 0.07, "y": 0.68 }, "kind": "quote", "text": "Two top users may be ~300 devices per year\n“Mayo in Arizona is their biggest center, and the second-biggest center is Methodist in Houston. Arizona might be doing 180 livers a year, something like that, with a pump. And then, Houston, maybe 100, 110.” -Transplant surgeon and division chief of the liver program at a world-renowned academic center", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:16.548+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "33e907bb-36a1-48fc-952e-5c2180b88b67", "parentComponentId": null }, { "bbox": { "h": 0.12, "w": 0.86, "x": 0.07, "y": 0.81 }, "kind": "quote", "text": "Henry Ford allegedly is one of TransMedics highest-volume users\n“Those are the biggest users that I know. And I think that MGH in Boston, I don’t know now that the chief of MGH is gone. He moved to UPenn, but the chief at MGH was one of the PIs for the initial trial, the PROTECT trial. They were using the pump in a fair number of patients. I also know that Henry Ford in Detroit, he was also using the machine quite a bit. Marwan Abouljoud.” - Transplant surgeon and division chief of the liver program at a world-renowned academic center", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:16.548+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "dd2e5fbc-ac79-4210-bcca-e8bc96384f29", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "“I would say that maybe those true religious zealots to Waleed represent 50% of the business.” — Prominent transplant surgeon, leadership role at a West Coast academic transplant center; “Mayo in Arizona is their biggest center, and the second-biggest center is Methodist in Houston. Arizona might be doing 180 livers a year, something like that, with a pump. And then, Houston, maybe 100, 110.” — Transplant surgeon and division chief of the liver program at a world-renowned academic center; “Those are the biggest users that I know. And I think that MGH in Boston, I don’t know now that the chief of MGH is gone. He moved to UPenn, but the chief at MGH was one of the PIs for the initial trial, the PROTECT trial. They were using the pump in a fair number of patients. I also know that Henry Ford in Detroit, he was also using the machine quite a bit. Marwan Abouljoud.” — Transplant surgeon and division chief of the liver program at a world-renowned academic center.", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:06+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a979-af414f03cfca", "parentComponentId": null }, { "bbox": { "h": 0.02, "w": 0.25, "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:16.548+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "68ff3ed2-dc79-443b-a5c9-9c00a5e520b3", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [ { "matchId": "21998245-6a89-420a-85e7-9b98fc496b1b", "evidence": "Uses expert surgeon quotes to validate revenue concentration claims.", "framework": null, "confidence": 0.9, "extraction": { "at": "2026-05-02 20:12:16.548+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 103, "frameworkName": "authority-citation" } ], "arcBeats": [], "loops": [], "locked": true }, { "page": 104, "type": "tension", "title": "The slide uses a Q&A transcript format to highlight defensive behavior from a subject.", "function": "expose_contradiction", "rawType": "expose_contradiction", "block": null, "metadata": { "slideType": "expose_contradiction", "slideTypeCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-124c-75aa-984a-0a3d0d8fc8df", "version": 1, "description": null }, "function": "expose_contradiction", "functionCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-171f-776f-887c-73edaff4cf9c", "version": 1, "description": null }, "density": "dense", "densityScore": 56, "componentCount": 6, "textChars": 3757, "nDataPoints": 0, "notes": "The slide uses a Q&A transcript format to highlight defensive behavior from a subject.", "elementsJson": [ "paragraph", "quote_block" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:12:17.03+00", "seconds": 3.878, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/104", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-104", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "One of TransMedics highest volume users played dumb and denied any interaction with TransMedics", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-23 01:18:10+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-70f3-714d-84bf-c0e3c111d7bf", "parentComponentId": null }, { "bbox": { "h": 0.03, "w": 0.86, "x": 0.07, "y": 0.51 }, "kind": "list", "text": "One of TransMedics highest volume users played dumb and denied any interaction with TransMedics", "attrs": null, "canon": { "kind": { "name": "List", "slug": "list", "status": "active", "canonId": "019de52c-f94b-779b-a53b-fd4904a5f4d2", "version": 1, "description": "Bullet or numbered list." }, "tool": null, "subkind": { "name": "Bullet list", "slug": "bullet", "status": "active", "canonId": "019de52c-fc98-7169-a083-5cab805076ca", "version": 1, "description": null }, "framework": null }, "subkind": "bullet", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:17.03+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "ce7233ac-db86-4ab2-a706-3816c24f67e6", "parentComponentId": null }, { "bbox": { "h": 0.38, "w": 0.86, "x": 0.07, "y": 0.55 }, "kind": "paragraph", "text": "A: “I don’t know the CEO at all. I don’t know him personally. Have I actually seen him, met him? Yes, but I don’t have any personal connection. I honestly don’t have any personal connection to anyone at the company. They’ve never asked for my opinion about anything. They’ve never asked me to do - nothing, really. I’ve never had an email from TransMedics.”\nQ: “Based on your volume, you are one of their highest volume users. Usually, companies do a full court press to at least stay in touch.”\nA: “Our transplant institute director may have more contact, but I certainly don’t. Honestly, I don’t invest in healthcare on purpose in any healthcare sector so that there’s no conflict of interest with my job. But I don’t know what their stock is doing. I have no idea what any of that stuff is doing. Because they’re a publicly traded company, right?... I am not by any means an insider to that circle....for kidney, I think we selectively use OCS. I do not have any involvement in kidney, so I don’t know.”\nQ: “They don’t have a kidney product.”\nA: “They don’t? Okay. Well then, there’s heart and lung, right?”\nQ: “And you run the liver transplant program there? You’re in charge of it?”\nA: “On the medical side, correct. I run the liver center. If I was someone that TransMedics in any way engaged with and I was involved in activities that they in any way sponsor, which I absolutely never have. I literally have never received as much as an email or communication from TransMedics other than updates on the data that they have or anything like that.” – Transplant hepatologist and director of the liver program at a Midwest academic center", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:17.03+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "32ba958f-1e51-4455-9a9b-10cece4d1c3d", "parentComponentId": null }, { "bbox": { "h": 0.42, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "paragraph", "text": "Our interview with one of the high-volume users of Middle East origin - we redact his name - was particularly amusing for the number of times he protested his “innocence,” a classic case of mens rea - “guilty mind” in Latin, a concept from criminal law - as we never asked about his ties to TransMedics. When we finally noted that he was a top user, he tap danced faster: “I don’t know the CEO at all. I don’t know him personally. Have I actually seen him, met him? Yes, but I don’t have any personal connection. I honestly don’t have any personal connection to anyone at this company. I’ve never had an email from TransMedics...honestly... there’s no conflict of interest...I don’t know what their stock is doing....I am not by any means an insider to that circle...I do not have any involvement...if I was someone that TransMedics in any way engaged with and I was involved with activities that they in any way sponsor...which I absolutely never have...I literally have never received as much as an email or communication from TransMedics...”", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:17.03+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "81045da9-8b19-46e8-a5c3-8db319e1acd4", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "I don't know the CEO at all. I don't know him personally. Have I actually seen him, met him? Yes, but I don't have any personal connection. I honestly don't have any personal connection to anyone at this company. I've never had an email from TransMedics...honestly... there's no conflict of interest...I don't know what their stock is doing....I am not by any means an insider to that circle...I do not have any involvement...if I was someone that TransMedics in any way engaged with and I was involved with activities that they in any way sponsor...which I absolutely never have...I literally have never received as much as an email or communication from TransMedics other than updates on the data that they have or anything like that. — Transplant hepatologist and director of the liver program at a Midwest academic center", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-23 01:18:10+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-70f3-714d-84bf-c421e0b36167", "parentComponentId": null }, { "bbox": { "h": 0.02, "w": 0.3, "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:17.03+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "8c98c337-2927-479c-be08-f834fcb74de3", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [], "arcBeats": [], "loops": [], "locked": true }, { "page": 105, "type": "tension", "title": "The slide uses a Q&A transcript format to present anecdotal evidence of potential unethical business practices.", "function": "expose_contradiction", "rawType": "expose_contradiction", "block": null, "metadata": { "slideType": "expose_contradiction", "slideTypeCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-124c-75aa-984a-0a3d0d8fc8df", "version": 1, "description": null }, "function": "expose_contradiction", "functionCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-171f-776f-887c-73edaff4cf9c", "version": 1, "description": null }, "density": "dense", "densityScore": 51, "componentCount": 7, "textChars": 1265, "nDataPoints": 0, "notes": "The slide uses a Q&A transcript format to present anecdotal evidence of potential unethical business practices.", "elementsJson": [ "headline_text", "paragraph", "callout_box" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:12:19.584+00", "seconds": 5.995, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/105", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-105", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "It is, but let me tell you something [chuckles]. There are certain things that are a little cloudy, especially with Methodist. So, the chief of transplant at Methodist, it is very well known, that he owns a lot of stock from TransMedics. That is a lot of conflict of interest there, which I don't know how he managed with the cost, but it is very well known by everybody that the chief of transplant at Houston Methodist owns a lot of their stock.", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:06+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a979-4dabae55aac4", "parentComponentId": null }, { "bbox": { "h": 0.45, "w": 0.86, "x": 0.07, "y": 0.34 }, "kind": "list", "text": "Transcript of Q&A session regarding TransMedics stock ownership and professional relationships.", "attrs": null, "canon": { "kind": { "name": "List", "slug": "list", "status": "active", "canonId": "019de52c-f94b-779b-a53b-fd4904a5f4d2", "version": 1, "description": "Bullet or numbered list." }, "tool": null, "subkind": { "name": "Bullet list", "slug": "bullet", "status": "active", "canonId": "019de52c-fc98-7169-a083-5cab805076ca", "version": 1, "description": null }, "framework": null }, "subkind": "bullet", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:19.584+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "fb66b9c8-4d5b-4f16-aa0a-ea03617f16bb", "parentComponentId": null }, { "bbox": { "h": 0.08, "w": 0.86, "x": 0.07, "y": 0.19 }, "kind": "paragraph", "text": "These surgeons indicated they have personal and/or professional relationships with both – \"certain things are a little cloudy, especially with Methodist...it is well-known that he owns a lot of stock from...that is a lot of conflict of interest there...it is very well known by everybody...this is not a secret.\"", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:19.584+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "5345f680-a0cc-45ad-8d7f-a0425aab2a1b", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "He's known as TransMedics' whore, basically? ... That's correct. — Transplant surgeon and division chief of the liver program at a world-renowned academic center", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:06+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a979-5303d8d0dae8", "parentComponentId": null }, { "bbox": { "h": 0.02, "w": 0.3, "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:19.584+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "eaec04b1-2f66-42c9-b9bc-f06dbaccd575", "parentComponentId": null }, { "bbox": { "h": 0.12, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "title", "text": "Multiple surgeons warned us about Ghobrial at Houston Methodist and Abouljoud at Henry Ford, expressing skepticism at the spike in their volumes.", "attrs": null, "canon": { "kind": { "name": "Title", "slug": "title", "status": "active", "canonId": "019de52c-f7dd-76d9-b848-b1f12bd85cf4", "version": 1, "description": "Slide title or headline." }, "tool": null, "subkind": { "name": "Headline", "slug": "headline", "status": "active", "canonId": "019de52c-fae1-7463-9a7c-d60668eced0d", "version": 1, "description": null }, "framework": null }, "subkind": "headline", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:19.584+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "5cc8422b-423b-4733-b9f7-335d7afe8f0f", "parentComponentId": null }, { "bbox": { "h": 0.02, "w": 0.35, "x": 0.07, "y": 0.31 }, "kind": "title", "text": "Alleged conflict of interest at Houston Methodist", "attrs": null, "canon": { "kind": { "name": "Title", "slug": "title", "status": "active", "canonId": "019de52c-f7dd-76d9-b848-b1f12bd85cf4", "version": 1, "description": "Slide title or headline." }, "tool": null, "subkind": { "name": "Subtitle", "slug": "subtitle", "status": "active", "canonId": "019de52c-fb09-739d-900c-815b0d9ac526", "version": 1, "description": null }, "framework": null }, "subkind": "subtitle", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:19.584+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "fc670cdf-91b7-4b4d-a10c-d46cc88d259f", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [], "arcBeats": [], "loops": [], "locked": true }, { "page": 106, "type": "tension", "title": "The slide uses a Q&A format to highlight potential ethical concerns regarding stock ownership and consulting arrangements.", "function": "expose_contradiction", "rawType": "expose_contradiction", "block": null, "metadata": { "slideType": "expose_contradiction", "slideTypeCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-124c-75aa-984a-0a3d0d8fc8df", "version": 1, "description": null }, "function": "expose_contradiction", "functionCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-171f-776f-887c-73edaff4cf9c", "version": 1, "description": null }, "density": "dense", "densityScore": 51, "componentCount": 6, "textChars": 2135, "nDataPoints": 0, "notes": "The slide uses a Q&A format to highlight potential ethical concerns regarding stock ownership and consulting arrangements.", "elementsJson": [ "paragraph", "quote_block", "footnote" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:12:17.361+00", "seconds": 3.552, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/106", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-106", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "The chief of a liver transplant program, who stated he knows Ghobrial well and appears to be in communication, indicated the relationship with TransMedics is improper and may be seen as a kickback.", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:06+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a979-374739eaa926", "parentComponentId": null }, { "bbox": { "h": 0.25, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "paragraph", "text": "The chief of a liver transplant program, who stated he knows Ghobrial well and appears to be in communication, indicated the relationship with TransMedics is improper and may be seen as a kickback...", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:17.361+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "0feb8430-ebf8-46f3-90e8-76e4d759d555", "parentComponentId": null }, { "bbox": { "h": 0.38, "w": 0.86, "x": 0.07, "y": 0.52 }, "kind": "paragraph", "text": "A: \"Certainly, Methodist is a huge user...yeah, the conflicts with Mark, you can see the obvious one...the Ghobrial relationship is a different flavor to me...it is a little bit different...there are similar backgrounds.\"\nQ: They're both Egyptian.\nA: \"And the stock ownership - one has to question that for sure. On our end, we're very, very, very intentional about not having any relationship with them or financial conflicts of interest and we cut those ties very early on after the trial.\"\nQ: \"Is Ghobrial, essentially a kickback - is that what it is with him?\"\nA: \"That's what I was going to say....the stock and consulting and stuff like that could potentially be seen as such in some manner. Mark's been fairly deliberate about having his junior folks out front in a lot of the talks and whatnot for TransMedics.\"\nQ: \"So, he's really promoting it. Is he viewed as a competent, ethical guy? It looks like he just kind of rode this horse, and their transplant volumes went through the roof.\"\nA: \"Yes. [Chuckles] I'm surprised, probably more than anybody, at their success with him at the helm but they've been very successful in growing a very big program. I'm surprised by it...having seen what they started with, I'm shocked that it has blown up into the program that it is.\" - Transplant surgeon at a high-volume academic center", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:17.361+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "5ae91c77-e5b8-4562-bf24-8b65fdad5709", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "Certainly, Methodist is a huge user...yeah, the conflicts with Mark, you can see the obvious one...the Ghobrial relationship is a different flavor to me...it is a little bit different...there are similar backgrounds. — Transplant surgeon at a high-volume academic center", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:06+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a979-3be8f891a3a2", "parentComponentId": null }, { "bbox": { "h": 0.02, "w": 0.3, "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:17.361+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "12d10258-2b40-4fc8-bfd2-6d514285eab3", "parentComponentId": null }, { "bbox": { "h": 0.03, "w": 0.55, "x": 0.07, "y": 0.48 }, "kind": "title", "text": "Transplant chief troubled by Ghobrial's conflicts of interest with TransMedics", "attrs": null, "canon": { "kind": { "name": "Title", "slug": "title", "status": "active", "canonId": "019de52c-f7dd-76d9-b848-b1f12bd85cf4", "version": 1, "description": "Slide title or headline." }, "tool": null, "subkind": { "name": "Headline", "slug": "headline", "status": "active", "canonId": "019de52c-fae1-7463-9a7c-d60668eced0d", "version": 1, "description": null }, "framework": null }, "subkind": "headline", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:17.361+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "28d687fd-c765-4c39-9492-b8fe66431ddf", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [ { "matchId": "ca1b86e6-7aae-4442-a125-42d6c9d66d6f", "evidence": "The slide explicitly frames the content as exposing potential kickbacks and conflicts of interest.", "framework": null, "confidence": 0.9, "extraction": { "at": "2026-05-02 20:12:17.361+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 106, "frameworkName": "fraud-exposure" } ], "arcBeats": [], "loops": [], "locked": true }, { "page": 107, "type": "tension", "title": "The slide uses Q&A transcripts to build a narrative of 'organ trafficking' or unethical donor selection.", "function": "expose_contradiction", "rawType": "expose_contradiction", "block": null, "metadata": { "slideType": "expose_contradiction", "slideTypeCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-124c-75aa-984a-0a3d0d8fc8df", "version": 1, "description": null }, "function": "expose_contradiction", "functionCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-171f-776f-887c-73edaff4cf9c", "version": 1, "description": null }, "density": "balanced", "densityScore": 37, "componentCount": 6, "textChars": 1013, "nDataPoints": 0, "notes": "The slide uses Q&A transcripts to build a narrative of 'organ trafficking' or unethical donor selection.", "elementsJson": [ "paragraph", "quote_block" ], "confidence": 0.9, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:12:16.987+00", "seconds": 3.062, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/107", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-107", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "As part of what we believe to be an organ steering or “trafficking” scheme orchestrated by TransMedics, surgeons indicated that the growth has come from accepting organs that reputable centers won’t touch.", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:06+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a979-c7fcb55bff07", "parentComponentId": null }, { "bbox": { "h": 0.45, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "paragraph", "text": "One surgeon after another questioned the transplant practices that led unremarkable centers like Ghobrial at Methodist and Abouljoud at Henry Ford to skyrocket – and their utilization of TransMedics with it...", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:16.987+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "0b53cd4b-06fc-4f29-8577-bd8b83763ee5", "parentComponentId": null }, { "bbox": { "h": 0.15, "w": 0.86, "x": 0.07, "y": 0.55 }, "kind": "paragraph", "text": "Houston Methodist allegedly implants livers from extremely old patients...", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:16.987+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "1654bb74-06a9-468f-9c96-e693543971e9", "parentComponentId": null }, { "bbox": { "h": 0.15, "w": 0.86, "x": 0.07, "y": 0.75 }, "kind": "paragraph", "text": "Transplant chief surprised by sudden growth at Methodist...", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:16.987+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "3f62d2a4-7a23-49a6-a6ff-82f4ebbdac4a", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "“we’re not in the business of transplanting people with 70-year old livers, like other places do. I know Methodist does a lot of older donors.” — Transplant hepatologist and director of the liver program at a Midwest academic center; “I’m surprised by it...having seen what they started with...I’m shocked that it has blown up into the program that it is.” — Transplant surgeon at a high volume academic center", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:06+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a979-cb22da94641d", "parentComponentId": null }, { "bbox": { "h": 0.03, "w": 0.3, "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:16.987+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "c8808e92-393d-4c12-85a6-da6bbb245c17", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [ { "matchId": "4e7dce55-c0d6-430c-bdfb-c169fa92c1dc", "evidence": "The slide explicitly frames the content as exposing a scheme or unethical practice.", "framework": null, "confidence": 0.9, "extraction": { "at": "2026-05-02 20:12:16.987+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 107, "frameworkName": "fraud-exposure" } ], "arcBeats": [], "loops": [], "locked": true }, { "page": 108, "type": "tension", "title": "The slide uses expert testimony to cast doubt on the quality of organs used by high-volume TransMedics users.", "function": "expose_contradiction", "rawType": "expose_contradiction", "block": null, "metadata": { "slideType": "expose_contradiction", "slideTypeCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-124c-75aa-984a-0a3d0d8fc8df", "version": 1, "description": null }, "function": "expose_contradiction", "functionCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-171f-776f-887c-73edaff4cf9c", "version": 1, "description": null }, "density": "dense", "densityScore": 53, "componentCount": 6, "textChars": 2396, "nDataPoints": 0, "notes": "The slide uses expert testimony to cast doubt on the quality of organs used by high-volume TransMedics users.", "elementsJson": [ "paragraph", "callout_box", "footnote" ], "confidence": 0.95, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:12:24.867+00", "seconds": 10.669, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/108", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-108", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "Highest-volume TransMedics users have allegedly ramped their transplant programs by using questionable organs", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:06+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a979-91ca6c8da872", "parentComponentId": null }, { "bbox": { "h": 0.45, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "paragraph", "text": "Surgeons singled out both Methodist and Mayo Arizona as growing their transplant and OCS volumes by being “willing to take organs that others haven’t been willing to” – we emphasize that this quote is from a liver transplant surgeon who may be the most respected KOL in the field, based at an academic center in Chicago. If perhaps the top transplant surgeon in the world won’t touch these organs, we wonder what makes Ghobrial, Mayo Arizona, and Abouljoud think they know something he doesn’t. Surgeons alleged that Ghobrial has “more than doubled” the size of his program through such questionable transplants, that “the guy at Mayo Clinic at Scottsdale has more than doubled theirs”; and that “Scottsdale went from being a medium-sized program to two years ago being the largest transplant program by volume in the country...I believe that was mostly through the expanded of organs, specifically OCS.”", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:24.867+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "0a57905d-a122-4f1f-868f-f1f9bbf75189", "parentComponentId": null }, { "bbox": { "h": 0.12, "w": 0.86, "x": 0.07, "y": 0.71 }, "kind": "quote", "text": "So, a place well-known for using TransMedics nationally is Mayo Scottsdale. Scottsdale went from being a medium-sized program to two years ago being the largest transplant program by volume in the country. I believe that was mostly through the expanded use of organs, specifically OCS, is my understanding.", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:24.867+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "71650f52-40f3-4e74-8639-b111596ba910", "parentComponentId": null }, { "bbox": { "h": 0.12, "w": 0.86, "x": 0.07, "y": 0.53 }, "kind": "quote", "text": "Mark Ghobrial has definitely grown his program, more than doubled its size. The guy at Mayo Clinic at Scottsdale has more than doubled theirs. Part of it is that they’re willing to take organs that others haven’t been willing to - older donors, all that stuff.", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:24.867+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "8ff003e4-5847-40fd-86aa-c732bd766ab0", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "“Mark Ghobrial has definitely grown his program, more than doubled its size. The guy in Mayo Clinic at Scottsdale has more than doubled theirs. Part of it is that they’re willing to take organs that others haven’t been willing to - older donors, all that stuff.” — One of the top liver transplant surgeons in the world, based at a leading Midwest academic center; “So, a place well-known for using TransMedics nationally is Mayo Scottsdale. Scottsdale went from being a medium-sized program to two years ago being the largest transplant program by volume in the country. I believe that was mostly through the expanded use of organs, specifically OCS, is my understanding.” — Transplant hepatologist and director of the liver program at a Midwest academic center", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:06+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a979-94811bf3c12a", "parentComponentId": null }, { "bbox": { "h": 0.02, "w": 0.25, "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:24.867+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "acca89d4-d70d-4895-bc44-00bd74f4549e", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [], "arcBeats": [], "loops": [], "locked": true }, { "page": 109, "type": "setup", "function": "transition", "rawType": "transition", "block": null, "metadata": { "slideType": "transition", "slideTypeCanon": { "name": "Transition", "slug": "transition", "status": "active", "canonId": "019de52d-0693-7766-9f05-887f41f8e41e", "version": 1, "description": null }, "function": "transition", "functionCanon": { "name": "Transition", "slug": "transition", "status": "active", "canonId": "019de52d-1365-7149-92aa-66df859e75fd", "version": 1, "description": null }, "density": "sparse", "densityScore": 10, "componentCount": 2, "textChars": 476, "nDataPoints": 0, "notes": null, "elementsJson": [ "paragraph" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:12:16.739+00", "seconds": 2.382, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/109", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-109", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "These high-volume users may allegedly be under scrutiny as part of multiple investigations by federal and states authorities and agencies, as well as by prominent news outlets, indicating the precarious nature of TransMedics business.", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:06+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a979-24ef28d093dd", "parentComponentId": null }, { "bbox": { "h": 0.158, "w": 0.854, "x": 0.073, "y": 0.07 }, "kind": "title", "text": "Part 4. These high-volume users may allegedly be under scrutiny as part of multiple investigations by federal and states authorities and agencies, as well as by prominent news outlets, indicating the precarious nature of TransMedics business.", "attrs": null, "canon": { "kind": { "name": "Title", "slug": "title", "status": "active", "canonId": "019de52c-f7dd-76d9-b848-b1f12bd85cf4", "version": 1, "description": "Slide title or headline." }, "tool": null, "subkind": { "name": "Headline", "slug": "headline", "status": "active", "canonId": "019de52c-fae1-7463-9a7c-d60668eced0d", "version": 1, "description": null }, "framework": null }, "subkind": "headline", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:16.739+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "2a4b2d5b-4abe-4271-847b-63004b2d3616", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [], "arcBeats": [], "loops": [], "locked": true }, { "page": 110, "type": "tension", "title": "The slide uses a Q&A format to highlight rumors of a Washington Post investigation into alleged kickbacks.", "function": "expose_contradiction", "rawType": "expose_contradiction", "block": null, "metadata": { "slideType": "expose_contradiction", "slideTypeCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-124c-75aa-984a-0a3d0d8fc8df", "version": 1, "description": null }, "function": "expose_contradiction", "functionCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-171f-776f-887c-73edaff4cf9c", "version": 1, "description": null }, "density": "balanced", "densityScore": 49, "componentCount": 5, "textChars": 2914, "nDataPoints": 0, "notes": "The slide uses a Q&A format to highlight rumors of a Washington Post investigation into alleged kickbacks.", "elementsJson": [ "paragraph", "quote_block", "footnote" ], "confidence": 0.9, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:12:18.046+00", "seconds": 3.477, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/110", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-110", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "We suspect that TransMedics and its highest-volume users may be under scrutiny as part of multiple federal/state regulatory investigations – which we would find unsurprising, irrespective of hearsay, given the flagrant conduct and rapidly unfolding backlash at centers across the US.", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:06+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a979-79ab1bf8f0ab", "parentComponentId": null }, { "bbox": { "h": 0.45, "w": 0.86, "x": 0.07, "y": 0.45 }, "kind": "list", "text": "Washington Post reporter allegedly reached out to surgeons regarding alleged kickbacks from TransMedics\nA: “I heard a little rumor, but again, this is rumor, okay? I heard that the Washington Post is working on a report because there is some concern that companies are giving kickbacks to some surgeons or hospitals for using the machine.”\nQ: “I saw that article. But that was talking about OPO’s. Was that talking about TransMedics—they didn’t mention TransMedics.”\nA: “No, no, no. This is something that is not published. I heard that there is a reporter working on TransMedics, specifically. This is not about OPO’s”\nQ: “You heard the Washington Post is working on TransMedics getting kickbacks?”\nA: “Yeah, that’s what I heard. But again, this is just a rumor that I heard from some people, that they are working on a report.”\nQ: “When did you hear this about the “Washington Post?”\nA: “I heard that a few months ago. The Washington Post was reaching out to some transplant surgeons across the country, like a very renowned transplant surgeon; I know that a reporter was reaching out to a surgeon because they were working on a report.” - Transplant surgeon and division chief of the liver program at a world-renowned academic center", "attrs": null, "canon": { "kind": { "name": "List", "slug": "list", "status": "active", "canonId": "019de52c-f94b-779b-a53b-fd4904a5f4d2", "version": 1, "description": "Bullet or numbered list." }, "tool": null, "subkind": { "name": "Bullet list", "slug": "bullet", "status": "active", "canonId": "019de52c-fc98-7169-a083-5cab805076ca", "version": 1, "description": null }, "framework": null }, "subkind": "bullet", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:18.046+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "eacac16c-2d31-4e8e-b548-8d7a1c3a5ec0", "parentComponentId": null }, { "bbox": { "h": 0.35, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "paragraph", "text": "We suspect that TransMedics and its highest-volume users may be under scrutiny as part of multiple federal/state regulatory investigations – which we would find unsurprising, irrespective of hearsay, given the flagrant conduct and rapidly unfolding backlash at centers across the US. Furthermore, a surgeon in a leadership role at a world-renowned center told us that the Washington Post has been “reaching out to some transplant surgeons across the country, like a very prominent surgeon...I know that a reporter was reaching out to a surgeon because they were working on a report.” We suspect the surgeon spoke with the reporter, given his stature in the field: “I heard that the Washington Post is working on a report because there is some concern that companies are giving kickbacks to some surgeons or hospitals for using the machine”; “this is something that is not published...I heard that there is a reporter working in TransMedics, specifically.”", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:18.046+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "36f7bcd0-027b-4386-afc4-0e17d544aaf7", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "I heard that the Washington Post is working on a report because there is some concern that companies are giving kickbacks to some surgeons or hospitals for using the machine; this is something that is not published...I heard that there is a reporter working in TransMedics, specifically. — Transplant surgeon and division chief of the liver program at a world-renowned academic center", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:06+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a979-7dc745f3d3c5", "parentComponentId": null }, { "bbox": { "h": 0.03, "w": 0.3, "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:18.046+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "26504d4b-57c4-4216-be6e-98e88e7061cd", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [], "arcBeats": [], "loops": [], "locked": true }, { "page": 111, "type": "tension", "title": "The slide uses a Q&A format to highlight rumors of financial incentives influencing hospital usage of TransMedics devices.", "function": "expose_contradiction", "rawType": "expose_contradiction", "block": null, "metadata": { "slideType": "expose_contradiction", "slideTypeCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-124c-75aa-984a-0a3d0d8fc8df", "version": 1, "description": null }, "function": "expose_contradiction", "functionCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-171f-776f-887c-73edaff4cf9c", "version": 1, "description": null }, "density": "balanced", "densityScore": 44, "componentCount": 5, "textChars": 1805, "nDataPoints": 0, "notes": "The slide uses a Q&A format to highlight rumors of financial incentives influencing hospital usage of TransMedics devices.", "elementsJson": [ "paragraph", "footnote" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:12:18.216+00", "seconds": 3.597, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/111", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-111", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "That something “big” may drop seems to be an open secret - transplant surgery is a small field where word travels fast.", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:06+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a979-62b1f4d2a645", "parentComponentId": null }, { "bbox": { "h": 0.45, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "paragraph", "text": "The surgeon indicated the Washington Post inquiries were recent, and while oblique, provided specifics about the reporter’s line of questioning that lend credibility: “because everybody is like, how is it possible that some of these hospitals are doing so many TransMedics? Because financially, it’s not possible to do too many...usually you tend to be believe that centers that use the device a lot – maybe they have some incentive to use it that much...Houston, maybe...Henry Ford, maybe....” Although he stated several times that this was rumor - “I heard a little rumor, but again, this is rumor, okay?” – we suspect that numerous surgeons, OPO’s, and transplant centers in the field have been interviewed by reporters and/or federal/state investigators, as several told us directly that they had been contacted and/or questioned. That something “big” may drop seems to be an open secret – transplant surgery is a small field where word travels fast, with only 400 surgeons in the US for liver and ~50-80 responsible for the vast majority, and even fewer for heart and lung.", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:18.216+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "7dbd30b2-7fc0-4102-936b-26796ee6690a", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "“because everybody is like, how is it possible that some of these hospitals are doing so many TransMedics? Because financially, it’s not possible to do too many...usually you tend to be believe that centers that use the device a lot - maybe they have some incentive to use it that much...Houston, maybe...Henry Ford, maybe....” — Transplant surgeon and division chief of the liver program at a world-renowned academic center", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:06+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a979-65f29b24c860", "parentComponentId": null }, { "bbox": { "h": 0.03, "w": 0.3, "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:18.216+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "74ddd4ee-a146-4945-a2c3-c9232b0ebfae", "parentComponentId": null }, { "bbox": { "h": 0.35, "w": 0.86, "x": 0.07, "y": 0.55 }, "kind": "table", "text": "Washington Post reporter allegedly reached out to surgeons regarding alleged kickbacks from TransMedics. Q&A transcript follows.", "attrs": null, "canon": { "kind": { "name": "Table", "slug": "table", "status": "active", "canonId": "019de52c-f9c8-7148-8119-eaac9594cd28", "version": 1, "description": "Tabular data layout." }, "tool": null, "subkind": { "name": "Data table", "slug": "data", "status": "active", "canonId": "019de52d-02d5-75b8-8abf-88e92bf63569", "version": 1, "description": null }, "framework": null }, "subkind": "data", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:18.216+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "d49d93eb-0754-4855-b621-197e1eb46b8a", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [ { "matchId": "e456e489-0f3b-4cec-b846-b30f48e49094", "evidence": "The slide explicitly discusses allegations of kickbacks and investigations by the Washington Post and federal/state investigators.", "framework": null, "confidence": 0.9, "extraction": { "at": "2026-05-02 20:12:18.216+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 111, "frameworkName": "fraud-exposure" } ], "arcBeats": [], "loops": [], "locked": true }, { "page": 112, "type": "tension", "title": "The slide uses a Q&A format to highlight specific allegations of bribery, kickbacks, and federal/state investigations.", "function": "expose_contradiction", "rawType": "expose_contradiction", "block": null, "metadata": { "slideType": "expose_contradiction", "slideTypeCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-124c-75aa-984a-0a3d0d8fc8df", "version": 1, "description": null }, "function": "expose_contradiction", "functionCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-171f-776f-887c-73edaff4cf9c", "version": 1, "description": null }, "density": "balanced", "densityScore": 43, "componentCount": 5, "textChars": 1705, "nDataPoints": 0, "notes": "The slide uses a Q&A format to highlight specific allegations of bribery, kickbacks, and federal/state investigations.", "elementsJson": [ "paragraph", "footnote" ], "confidence": 0.95, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:12:17.785+00", "seconds": 3.09, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/112", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-112", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "It sounds to me like a bribery, pay-to-play kind of thing.", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:06+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a979-0ce68b9f6afd", "parentComponentId": null }, { "bbox": { "h": 0.42, "w": 0.88, "x": 0.07, "y": 0.49 }, "kind": "list", "text": "Q: “A surgeon I just talked to said I’ll tell you who their whores are. He mentioned a couple of very high-volume users. It sounds to me like a bribery, pay-to-play kind of thing.” A: “There’s so much that’s going on to be found out. Do you know everything that’s going on with the OIG and DOJ and the IRS?” Q: “I read that Washington Post article.” A: “It’s deeper than that, and I’ll let you know because I’ve been interviewed for it.” Q: “Walk me through what you’re seeing. And how TransMedics may be a part of this stuff that the Washington Post is talking about as far as kickbacks.” A: “Here’s all the drama. [Redacted] recently interviewed with the Department of Justice, the OIG, and the IRS. And with the DOJ out of Washington and out of New York, in particular. And then the state attorney general is getting involved in this as well because if there’s Medicare fraud, then there’s Medicaid fraud. And probably the most prominent attorney general that’s getting involved is Virginia, and the reason why that’s important is because UNOS is there, and so is A-OPO, which is the OPO governing body, not a governing body but a trade association, and they also have a terrible OPO based there.”– CEO of a major OPO (Organ Procurement Organization), longtime industry executive", "attrs": null, "canon": { "kind": { "name": "List", "slug": "list", "status": "active", "canonId": "019de52c-f94b-779b-a53b-fd4904a5f4d2", "version": 1, "description": "Bullet or numbered list." }, "tool": null, "subkind": { "name": "Bullet list", "slug": "bullet", "status": "active", "canonId": "019de52c-fc98-7169-a083-5cab805076ca", "version": 1, "description": null }, "framework": null }, "subkind": "bullet", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:17.785+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "2f0a0b80-7309-4179-95b2-1ee0c76f6b43", "parentComponentId": null }, { "bbox": { "h": 0.03, "w": 0.85, "x": 0.07, "y": 0.46 }, "kind": "paragraph", "text": "Multiple regulatory and law enforcement agencies at a federal and state level allegedly interviewing industry participants", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:17.785+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "27d1299f-a888-4831-929e-59461d9dafa4", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "“A surgeon I just talked to said I'll tell you who their whores are. He mentioned a couple of very high-volume users. It sounds to me like a bribery, pay-to-play kind of thing.” — Surgeon", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:06+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a979-1272e5c383e0", "parentComponentId": null }, { "bbox": { "h": 0.02, "w": 0.25, "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:17.785+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "16a336fd-92d7-4add-8d61-6a6e476d0633", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [], "arcBeats": [], "loops": [], "locked": true }, { "page": 113, "type": "tension", "title": "The slide uses a Q&A format to highlight the 'reasonable cost' loophole and the potential for government crackdown.", "function": "expose_contradiction", "rawType": "expose_contradiction", "block": null, "metadata": { "slideType": "expose_contradiction", "slideTypeCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-124c-75aa-984a-0a3d0d8fc8df", "version": 1, "description": null }, "function": "expose_contradiction", "functionCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-171f-776f-887c-73edaff4cf9c", "version": 1, "description": null }, "density": "dense", "densityScore": 50, "componentCount": 7, "textChars": 1219, "nDataPoints": 0, "notes": "The slide uses a Q&A format to highlight the 'reasonable cost' loophole and the potential for government crackdown.", "elementsJson": [ "paragraph", "quote_block" ], "confidence": 0.95, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:12:18.006+00", "seconds": 3.066, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/113", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-113", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "Regulators crosshairs are focused on the Cost Report, the loophole at the center of TransMedics' extortionate pricing for consumables and air transport.", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-23 01:18:10+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-70f3-714d-84bf-d7f5b7bf5ef5", "parentComponentId": null }, { "bbox": { "h": 0.25, "w": 0.9, "x": 0.05, "y": 0.7 }, "kind": "list", "text": "No oversight of 'reasonable cost' cost bucket; 'getting abused' and regulators will fix", "attrs": null, "canon": { "kind": { "name": "List", "slug": "list", "status": "active", "canonId": "019de52c-f94b-779b-a53b-fd4904a5f4d2", "version": 1, "description": "Bullet or numbered list." }, "tool": null, "subkind": { "name": "Bullet list", "slug": "bullet", "status": "active", "canonId": "019de52c-fc98-7169-a083-5cab805076ca", "version": 1, "description": null }, "framework": null }, "subkind": "bullet", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:18.006+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "ce13ec72-a44b-45a3-89c4-eeb39ccb472b", "parentComponentId": null }, { "bbox": { "h": 0.1, "w": 0.9, "x": 0.05, "y": 0.2 }, "kind": "paragraph", "text": "Regulators crosshairs are focused on the Cost Report, the loophole at the center of TransMedics' extortionate pricing for consumables and air transport.", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:18.006+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "10662fdd-e4b9-4fe7-9809-65736e52f053", "parentComponentId": null }, { "bbox": { "h": 0.2, "w": 0.9, "x": 0.05, "y": 0.45 }, "kind": "quote", "text": "OIG recently announced that they're going to investigate every single OPO, and they're going to investigate every single transplant program... A lot of what their investigation has to do with our Cost Report.", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:18.006+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "aaa3ee52-33b7-4696-8a8d-f6a0e02d9a2f", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "OIG recently announced that they’re going to investigate every single OPO, and they’re going to investigate every single transplant program, and it’s going to happen by the end of 2025. ... I’d say I owe you 5 grand times however many kidneys I transplanted because I’ve been overcharging the whole time. — CEO of a major OPO (Organ Procurement Organization), longtime industry executive", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-23 01:18:10+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-70f3-714d-84bf-d955f7caf3c7", "parentComponentId": null }, { "bbox": { "h": 0.03, "w": 0.3, "x": 0.05, "y": 0.95 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:18.006+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "8cdfe8a6-24c4-49c0-a8ce-67b1975dc549", "parentComponentId": null }, { "bbox": { "h": 0.15, "w": 0.9, "x": 0.05, "y": 0.05 }, "kind": "title", "text": "The CEO of the OPO implied an extensive, far-reaching OIG investigation into industry practices and suggested that TransMedics is vulnerable, indicating potential action in 2025", "attrs": null, "canon": { "kind": { "name": "Title", "slug": "title", "status": "active", "canonId": "019de52c-f7dd-76d9-b848-b1f12bd85cf4", "version": 1, "description": "Slide title or headline." }, "tool": null, "subkind": { "name": "Headline", "slug": "headline", "status": "active", "canonId": "019de52c-fae1-7463-9a7c-d60668eced0d", "version": 1, "description": null }, "framework": null }, "subkind": "headline", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:18.006+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "a866e677-e551-4a86-86f1-9768dc659ba4", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [ { "matchId": "282574ec-cbf7-4fad-ab4c-ecd1ca3d5abc", "evidence": "The slide highlights a specific loophole in cost reporting being abused by industry players.", "framework": null, "confidence": 0.9, "extraction": { "at": "2026-05-02 20:12:18.006+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 113, "frameworkName": "fraud-exposure" } ], "arcBeats": [], "loops": [], "locked": true }, { "page": 114, "type": "tension", "title": "The slide uses direct quotes from an industry executive to frame TransMedics as a target for regulatory investigation.", "function": "name_villain", "rawType": "villain_critique", "block": null, "metadata": { "slideType": "villain_critique", "slideTypeCanon": { "name": "Villain critique", "slug": "villain_critique", "status": "active", "canonId": "019de52d-10bc-7136-bf20-09de59d17447", "version": 1, "description": null }, "function": "name_villain", "functionCanon": { "name": "Name villain", "slug": "name_villain", "status": "active", "canonId": "019de52d-1746-70d6-bc58-5eeaf5865526", "version": 1, "description": null }, "density": "balanced", "densityScore": 36, "componentCount": 6, "textChars": 970, "nDataPoints": 0, "notes": "The slide uses direct quotes from an industry executive to frame TransMedics as a target for regulatory investigation.", "elementsJson": [ "paragraph", "quote_block", "footnote" ], "confidence": 0.9, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:12:20.59+00", "seconds": 5.612, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/114", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-114", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "I think the gravy train is coming to an end, honestly.", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:07+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a979-d9cd8c817a09", "parentComponentId": null }, { "bbox": { "h": 0.45, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "paragraph", "text": "The OPO executive stated that TransMedics is a creature of this abusive reimbursement loophole and that regulators are locked in and ready to blow up its gravy train.", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:20.59+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "e790f7e6-5c65-47c7-b5bd-c4de2670574b", "parentComponentId": null }, { "bbox": { "h": 0.25, "w": 0.86, "x": 0.07, "y": 0.69 }, "kind": "quote", "text": "So, there's a lot that you can do on the OPO side and you can do on the transplant center side in terms of cost shift...", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:20.59+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "6360f5ba-e4b5-4adf-941e-56a90d2462c7", "parentComponentId": null }, { "bbox": { "h": 0.15, "w": 0.86, "x": 0.07, "y": 0.51 }, "kind": "quote", "text": "So, I really think the government is going to come in, and they're really going to shake this up...", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:20.59+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "c1a7d80d-902c-408c-a533-14dc0fb254b5", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "“So, I really think the government is going to come in, and they're really going to shake this up, and I think the glory days of we're going to charge $100,000 for a TransMedics device, and you have to use our people, and you've got to use our expensive jet - I think all that is over. I think the gravy train is coming to an end, honestly. I think the government is going to really come in.” — CEO of a major OPO (Organ Procurement Organization), longtime industry executive", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:07+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a979-df1cc622336e", "parentComponentId": null }, { "bbox": { "h": 0.03, "w": 0.3, "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:20.59+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "9b0bad7e-126a-4e85-882f-783f46fc1499", "parentComponentId": null } ], "metrics": [], "tools": [ { "tool": { "name": "Anadiplosis", "slug": "anadiplosis", "status": "active", "bestFor": null, "canonId": "019dd956-a0a5-75f9-a98c-7b7d8ee377a1", "version": 1, "bodyDocId": null, "description": "Ending one clause with a word that begins the next", "familyLabel": null, "categoryName": "Loop", "categorySlug": "loop" }, "agent": "Storyteller", "layer": "slide", "agents": [ "Storyteller" ], "matchId": "fd95669a-cb48-4581-b292-6658ea7cc777", "evidence": "The repetition of 'I think the government is going to come in, and they're really going to shake this up' emphasizes the predicted regulatory action.", "pageRefs": null, "priority": null, "whenToUse": null, "confidence": 0.7, "extraction": { "at": "2026-07-16 23:10:31.773404+00", "model": "or:meta-llama/llama-4-scout", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 114, "whyItWorks": null, "antipattern": null, "cardinality": null, "narrativePurpose": null }, { "tool": { "name": "Villain slide", "slug": "villain-slide", "status": "active", "bestFor": "In activist decks where the personality matters", "canonId": "019dd9e1-518c-7404-976a-5be5a517b659", "version": 1, "bodyDocId": null, "description": "A dedicated slide presenting the named villain visually", "familyLabel": null, "categoryName": null, "categorySlug": null }, "agent": null, "layer": "slide", "agents": null, "matchId": "e445994b-3853-41b9-9212-3d9098018ca5", "evidence": "The slide presents a critical view of TransMedics, labeling it as a 'creature of this abusive reimbursement loophole' and suggesting regulatory action is imminent.", "pageRefs": null, "priority": null, "whenToUse": "In activist decks where the personality matters", "confidence": 0.9, "extraction": { "at": "2026-07-16 23:10:31.739183+00", "model": "or:meta-llama/llama-4-scout", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 114, "whyItWorks": "Makes the antagonist concrete", "antipattern": null, "cardinality": null, "narrativePurpose": null } ], "frameworks": [], "arcBeats": [], "loops": [], "locked": true }, { "page": 115, "type": "tension", "title": "The slide uses a Q&A format to highlight a specific industry expert's bearish view on TransMedics.", "function": "expose_contradiction", "rawType": "ceo_quote", "block": null, "metadata": { "slideType": "ceo_quote", "slideTypeCanon": { "name": "CEO quote", "slug": "ceo_quote", "status": "active", "canonId": "019de52d-09b6-71c8-93a5-f90a9772a8fa", "version": 1, "description": null }, "function": "expose_contradiction", "functionCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-171f-776f-887c-73edaff4cf9c", "version": 1, "description": null }, "density": "dense", "densityScore": 53, "componentCount": 5, "textChars": 2683, "nDataPoints": 2, "notes": "The slide uses a Q&A format to highlight a specific industry expert's bearish view on TransMedics.", "elementsJson": [ "paragraph", "quote_block", "footnote" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:12:17.723+00", "seconds": 2.733, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/115", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-115", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "The OPO executive emphasized the exploitation of “Reasonable Cost” as the heart of TransMedics scam – without it, we note that traditional kidney pumps sell for a mere $2,000 – and its game over now that government is about to define what reasonable cost actually is.", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:08+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a97a-ef3608c3f2dc", "parentComponentId": null }, { "bbox": { "h": 0.28, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "paragraph", "text": "The OPO executive emphasized the exploitation of “Reasonable Cost” as the heart of TransMedics scam – without it, we note that traditional kidney pumps sell for a mere $2,000 – and its game over now that government is about to define what reasonable cost actually is: “they’re going to come in because everything in transplant is based on what’s a reasonable cost...the government is working their way down...this stuff is all new...they’ve never established what reasonable costs are...they’re going to come in an establish ‘reasonable cost’...and now, all of a sudden, the Hawker 800 that costs $12 million does not make sense anymore because that’s not reasonable cost.”", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:17.723+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "6cf0c8cc-23b2-43de-aa94-9885758e92e2", "parentComponentId": null }, { "bbox": { "h": 0.28, "w": 0.86, "x": 0.07, "y": 0.42 }, "kind": "quote", "text": "Q: “So, you think the government is going to wipe out TransMedics’ gravy train?” A: “I think so. I think they’re going to come in because everything in transplant is based on what’s a reasonable cost... I think the government is working their way down... I think they’re going to come in and they’re going to establish “reasonable cost.” And now, all of a sudden, the Hawker 800 that costs $12 million does not make sense because that’s not reasonable cost.” - CEO of a major OPO (Organ Procurement Organization), longtime industry executive", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:17.723+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "1097b525-c98a-4fcd-99c5-3d899d3abbb9", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "“I think they’re going to come in because everything in transplant is based on what’s a reasonable cost. When you look at this stuff, you look at TransMedics and you look at this logistics stuff and things like that, the expense recovery, it’s very transparent what it costs. It doesn’t cost a ton and it’s used a bunch. And then you work your way down to devices and like TransMedics, and it’s like, okay, well on a medical device, it costs a lot, it’s somewhat transparent, and used kind of a lot. And then you go down to logistics, one step further, there’s no transparency, it’s used all the time, and it’s extremely expensive. I think the government is working their way down. Because what CMS does is like, what’s a reasonable cost? Well, this stuff is all new, so they’ve never established what reasonable costs are. I think what they’re going to do is I think they’re going to come in and they’re going to establish ‘reasonable cost.’ And now, all of a sudden, the Hawker 800 that costs $12 million does not make sense because that’s not reasonable cost.” — CEO of a major OPO (Organ Procurement Organization), longtime industry executive", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:08+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a97a-f06005980abd", "parentComponentId": null }, { "bbox": { "h": 0.02, "w": 0.25, "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:17.723+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "0996a25e-4a34-4269-8740-0a124d1ac2c4", "parentComponentId": null } ], "metrics": [], "tools": [ { "tool": { "name": "CEO quote contradiction", "slug": "ceo-quote-contradiction", "status": "active", "bestFor": "When management credibility is the lever", "canonId": "019dd9e1-52e9-717f-8454-93e627563ed6", "version": 1, "bodyDocId": "019dd9a1-8296-720d-8f51-da76937f9415", "description": "You reproduce management's own words — verbatim, with source and date — and\nthen place them next to the outcome that contradicts them. The CEO built\nthe rope; you put it around their own neck.", "familyLabel": null, "categoryName": null, "categorySlug": null }, "agent": null, "layer": "slide", "agents": null, "matchId": "ced44070-92d0-4b7c-a0de-6231397fee40", "evidence": "The OPO executive's statement highlights the exploitation of 'Reasonable Cost' by TransMedics, contrasting with traditional kidney pumps.", "pageRefs": null, "priority": null, "whenToUse": "When management credibility is the lever", "confidence": 0.8, "extraction": { "at": "2026-07-16 23:10:31.838302+00", "model": "or:meta-llama/llama-4-scout", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 115, "whyItWorks": "- **Maximum credibility**: no adjective you could write is as damning as the\n target's own prior statement.\n- **No rebuttal path**: management can't argue they didn't say it.\n- **It forces accountability onto a person**, not an institution — even if\n you aren't explicitly naming a villain elsewhere.\n- **Reporters amplify it**. A CEO-quote-contradiction slide is quotable,\n which means it lands in WSJ/FT/Bloomberg coverage.", "antipattern": null, "cardinality": null, "narrativePurpose": null } ], "frameworks": [ { "matchId": "cd77a495-ac4f-496e-aa8b-bcbb401920aa", "evidence": "Uses an industry expert quote to undermine the company's business model.", "framework": null, "confidence": 0.9, "extraction": { "at": "2026-05-02 20:12:17.723+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 115, "frameworkName": "ceo-quote-contradiction" } ], "arcBeats": [], "loops": [], "locked": true }, { "page": 116, "type": "evidence", "title": "Contains highlighted text segments within the quotes.", "function": "cite_precedent", "rawType": "quote_slide", "block": null, "metadata": { "slideType": "quote_slide", "slideTypeCanon": { "name": "Quote slide", "slug": "quote_slide", "status": "active", "canonId": "019de52d-098e-7555-a9fd-4f0af7e80bc2", "version": 1, "description": null }, "function": "cite_precedent", "functionCanon": { "name": "Cite precedent", "slug": "cite_precedent", "status": "active", "canonId": "019de52d-142b-714b-86d4-58aad7b568ec", "version": 1, "description": null }, "density": "dense", "densityScore": 55, "componentCount": 8, "textChars": 1069, "nDataPoints": 0, "notes": "Contains highlighted text segments within the quotes.", "elementsJson": [ "paragraph", "quote_block" ], "confidence": 0.95, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:12:18.055+00", "seconds": 3.015, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/116", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-116", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "TransMedics entire model, as a creature of this abusive regime, appears to be in jeopardy", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-23 01:18:10+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-70f3-714d-84bf-e988e7a3cd81", "parentComponentId": null }, { "bbox": { "h": 0.03, "w": 0.6, "x": 0.07, "y": 0.62 }, "kind": "paragraph", "text": "New OPTN governance model is a preview of crackdown in organ transplant abuses", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:18.055+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "340669dc-f9f0-41c6-b134-ebf3307e7856", "parentComponentId": null }, { "bbox": { "h": 0.03, "w": 0.55, "x": 0.07, "y": 0.44 }, "kind": "paragraph", "text": "New IOTA model is a precursor to government scrutiny of the gravy train", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:18.055+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "d018675a-03a9-4464-b943-ada96116f7a1", "parentComponentId": null }, { "bbox": { "h": 0.12, "w": 0.86, "x": 0.07, "y": 0.47 }, "kind": "quote", "text": "And then they just released what's called IOTA... they're going to pick winners, and they're going to pick losers. - CEO of a major OPO", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:18.055+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "16febcab-a461-42fd-9a8d-df04ae27fa7d", "parentComponentId": null }, { "bbox": { "h": 0.25, "w": 0.86, "x": 0.07, "y": 0.65 }, "kind": "quote", "text": "The OPTN... that OPTN contract that's held by UNOS... is getting completely broken up... the government is coming in, and they're going to start controlling a lot of this. - CEO of a major OPO", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:18.055+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "2acdf4bd-10a6-4a1b-a9f8-e45c4373fae7", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "Essentially, I think what's going to happen is at the end of 2025, they're going to have all these investigations wrapped up, and they're going to put everything down, and they're going to pick winners, and they're going to pick losers. — CEO of a major OPO (Organ Procurement Organization), longtime industry executive", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-23 01:18:10+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-70f3-714d-84bf-ee18c0b8eaa1", "parentComponentId": null }, { "bbox": { "h": 0.02, "w": 0.3, "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:18.055+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "0f724128-b4c2-4280-9635-86a77de52b6a", "parentComponentId": null }, { "bbox": { "h": 0.15, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "title", "text": "The OPO executive offered real-time intelligence regarding a rapidly developing regulatory tsunami in the organ transplant arena.", "attrs": null, "canon": { "kind": { "name": "Title", "slug": "title", "status": "active", "canonId": "019de52c-f7dd-76d9-b848-b1f12bd85cf4", "version": 1, "description": "Slide title or headline." }, "tool": null, "subkind": { "name": "Headline", "slug": "headline", "status": "active", "canonId": "019de52c-fae1-7463-9a7c-d60668eced0d", "version": 1, "description": null }, "framework": null }, "subkind": "headline", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:18.055+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "781a3407-1386-41ce-8c27-2239b3fac243", "parentComponentId": null } ], "metrics": [], "tools": [ { "tool": { "name": "Cliffhanger", "slug": "cliffhanger", "status": "active", "bestFor": null, "canonId": "019dd956-a34c-72a7-8c35-2ae14a425acb", "version": 1, "bodyDocId": null, "description": "Ending a section at moment of suspense to maintain engagement", "familyLabel": null, "categoryName": "Loop", "categorySlug": "loop" }, "agent": "Storyteller", "layer": "slide", "agents": [ "Storyteller" ], "matchId": "079f794e-93c5-4204-ae80-7d53ce4eb896", "evidence": "The slide mentions a 'regulatory tsunami' and the breaking up of the OPTN contract, creating a sense of impending change.", "pageRefs": null, "priority": null, "whenToUse": null, "confidence": 0.7, "extraction": { "at": "2026-07-16 23:10:31.905465+00", "model": "or:meta-llama/llama-4-scout", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 116, "whyItWorks": null, "antipattern": null, "cardinality": null, "narrativePurpose": null } ], "frameworks": [ { "matchId": "27bb7443-7283-409d-9e76-a539f3717ae3", "evidence": "Citing a CEO of a major OPO to validate regulatory risk", "framework": null, "confidence": 0.9, "extraction": { "at": "2026-05-02 20:12:18.055+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 116, "frameworkName": "authority-citation" } ], "arcBeats": [], "loops": [], "locked": true }, { "page": 117, "type": "tension", "title": "The slide uses a Q&A format to highlight a specific allegation of regulatory non-compliance.", "function": "expose_contradiction", "rawType": "expose_contradiction", "block": null, "metadata": { "slideType": "expose_contradiction", "slideTypeCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-124c-75aa-984a-0a3d0d8fc8df", "version": 1, "description": null }, "function": "expose_contradiction", "functionCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-171f-776f-887c-73edaff4cf9c", "version": 1, "description": null }, "density": "balanced", "densityScore": 41, "componentCount": 5, "textChars": 1544, "nDataPoints": 0, "notes": "The slide uses a Q&A format to highlight a specific allegation of regulatory non-compliance.", "elementsJson": [ "paragraph", "quote_block", "footnote" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:12:17.443+00", "seconds": 2.392, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/117", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-117", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "We immediately noticed that the total payments reported by TransMedics are unusually low, which suggests a company trying to cover-up the amounts it pays.", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:07+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a97a-404a9e2096d8", "parentComponentId": null }, { "bbox": { "h": 0.25, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "paragraph", "text": "Anytime we research a fraudulent biotech or medtech company, we check the CMS OpenPayments database... We immediately noticed that the total payments reported by TransMedics are unusually low, which suggests a company trying to cover-up the amounts it pays.", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:17.443+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "f485b833-dc75-4411-a11f-6b37824d8fbd", "parentComponentId": null }, { "bbox": { "h": 0.35, "w": 0.86, "x": 0.07, "y": 0.56 }, "kind": "quote", "text": "Allegedly refusing to report payments to doctors to OpenPayments. A: If you open their open payments page... there's a glaring omission... And they say it doesn't apply to them. Q: You're saying they're just not reporting a lot of stuff to open payments. A: Yeah.", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:17.443+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "637357e7-3ace-4a0e-83af-fcab34faa374", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "“If you open their open payments page and the types of payments that have been paid to providers, there's a glaring omission...I said I have noticed that every time I take a doctor to dinner and I send you all of the requirements for open payments requirements, it comes back to me as I don't need this but thank you. And when I say, well, it's part of the open payments requirements, and here are the NCI numbers for all of the doctors that were out to dinner that I took them to, they said, we're not part of AdvaMed, so that doesn't apply to us. AdvaMed is the medical device association, and they put forward a statement, like a thought paper, on how you should comply and what's the process to comply with this regulation. And they say it doesn't apply to them.” — Former executive in a key reimbursement role", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:07+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a97a-447947401584", "parentComponentId": null }, { "bbox": { "h": 0.02, "w": 0.3, "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:17.443+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "3cd89ffc-2c6f-4f9b-a632-5cd5c8a3a023", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [ { "matchId": "5df818e2-da4b-4525-bc77-2d5b6f6ccb0f", "evidence": "The slide explicitly frames the company's actions as a cover-up of regulatory reporting requirements.", "framework": null, "confidence": 0.9, "extraction": { "at": "2026-05-02 20:12:17.443+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 117, "frameworkName": "fraud-exposure" } ], "arcBeats": [], "loops": [], "locked": true }, { "page": 118, "type": "tension", "title": "The slide uses red circles and arrows to annotate screenshots of the CMS Open Payments database to point out irregularities.", "function": "expose_contradiction", "rawType": "expose_contradiction", "block": null, "metadata": { "slideType": "expose_contradiction", "slideTypeCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-124c-75aa-984a-0a3d0d8fc8df", "version": 1, "description": null }, "function": "expose_contradiction", "functionCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-171f-776f-887c-73edaff4cf9c", "version": 1, "description": null }, "density": "balanced", "densityScore": 47, "componentCount": 6, "textChars": 1192, "nDataPoints": 5, "notes": "The slide uses red circles and arrows to annotate screenshots of the CMS Open Payments database to point out irregularities.", "elementsJson": [ "paragraph", "screenshot", "pie_chart", "data_table" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:12:18.985+00", "seconds": 3.775, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/118", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-118", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "We also note the cluster of fifteen “consulting” payments of exactly $50,000 each, mostly paid on the same day to various doctors – suggestive of kickbacks – as well as other suspicious clusters in the data.", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:07+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a979-f0df95965220", "parentComponentId": null }, { "bbox": { "h": 0.42, "w": 0.44, "x": 0.07, "y": 0.48 }, "kind": "image", "text": "Screenshots of CMS Open Payments data showing totals and payment nature breakdown.", "attrs": null, "canon": { "kind": { "name": "Image", "slug": "image", "status": "active", "canonId": "019de52c-f978-701f-a720-51d029d769e7", "version": 1, "description": "Photo, illustration, screenshot or icon." }, "tool": null, "subkind": { "name": "Screenshot", "slug": "screenshot", "status": "active", "canonId": "019de52c-fd87-7509-8391-3d79fb339379", "version": 1, "description": null }, "framework": null }, "subkind": "screenshot", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:18.985+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "a808090d-8b86-4443-bb16-55272a84e0c8", "parentComponentId": null }, { "bbox": { "h": 0.42, "w": 0.42, "x": 0.51, "y": 0.48 }, "kind": "image", "text": "Screenshot of payment records showing repeated $50,000 consulting fees.", "attrs": null, "canon": { "kind": { "name": "Image", "slug": "image", "status": "active", "canonId": "019de52c-f978-701f-a720-51d029d769e7", "version": 1, "description": "Photo, illustration, screenshot or icon." }, "tool": null, "subkind": { "name": "Screenshot", "slug": "screenshot", "status": "active", "canonId": "019de52c-fd87-7509-8391-3d79fb339379", "version": 1, "description": null }, "framework": null }, "subkind": "screenshot", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:18.985+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "ff8faace-e25b-4646-bd9d-985db7f0e62b", "parentComponentId": null }, { "bbox": null, "kind": "metric", "text": "General Payments: $1.5MM", "attrs": null, "canon": { "kind": { "name": "Metric", "slug": "metric", "status": "active", "canonId": "019de52c-f923-73bf-8081-d0b1a8c5264d", "version": 1, "description": "Big-number or KPI value." }, "tool": { "name": "Quantification", "slug": "quantification", "status": "active", "bestFor": null, "canonId": "019dd9e1-47ab-72ce-a079-aab1f5299e88", "version": 1, "bodyDocId": null, "description": "Translating a claim into numbers, charts, or tables.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": "primary", "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:07+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a979-f468e79f074b", "parentComponentId": null }, { "bbox": { "h": 0.32, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "paragraph", "text": "The executive detailed several anomalies in TransMedics entries on Open Payments. We note that the annual amount for “General Payments” was a mere $1.5MM in 2023, straining credibility. For example, the executive pointed to the absence of payment entries for “Food and Drink” – typically a large sum with the largest number of discrete payments, as wining and dining at expensive restaurants at conferences or speaker events is a common mechanism for inducement. We also note the cluster of fifteen “consulting” payments of exactly $50,000 each, mostly paid on the same day to various doctors – suggestive of kickbacks – as well as other suspicious clusters in the data.", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:18.985+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "cd5d810c-a9cf-4fc1-9568-d9b7a4746b03", "parentComponentId": null }, { "bbox": { "h": 0.03, "w": 0.75, "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts; CMS Open Payments database https://openpaymentsdata.cms.gov/company/100000010939", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:18.985+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "a311a556-eef6-4d56-ae47-5fc413b21843", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [ { "matchId": "ed619cdc-0cad-450c-923c-75949a1324df", "evidence": "The slide explicitly identifies 'anomalies' and 'suggestive of kickbacks' in financial data.", "framework": null, "confidence": 0.9, "extraction": { "at": "2026-05-02 20:12:18.985+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 118, "frameworkName": "fraud-exposure" } ], "arcBeats": [], "loops": [], "locked": true }, { "page": 119, "type": "tension", "title": "The slide uses a Q&A format to build a case of corporate malfeasance or regulatory avoidance.", "function": "expose_contradiction", "rawType": "expose_contradiction", "block": null, "metadata": { "slideType": "expose_contradiction", "slideTypeCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-124c-75aa-984a-0a3d0d8fc8df", "version": 1, "description": null }, "function": "expose_contradiction", "functionCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-171f-776f-887c-73edaff4cf9c", "version": 1, "description": null }, "density": "dense", "densityScore": 60, "componentCount": 7, "textChars": 1616, "nDataPoints": 2, "notes": "The slide uses a Q&A format to build a case of corporate malfeasance or regulatory avoidance.", "elementsJson": [ "paragraph", "quote_block", "footnote" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:12:18.475+00", "seconds": 3.23, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/119", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-119", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "The lack of Open Payments reporting is striking given what surgeons detailed as lavish, unusual travel inducements.", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:07+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a97a-2b6f528bcea7", "parentComponentId": null }, { "bbox": { "h": 0.42, "w": 0.86, "x": 0.07, "y": 0.51 }, "kind": "list", "text": "Q&A transcript excerpts highlighting first-class travel, hotel stays, and large group sizes.", "attrs": null, "canon": { "kind": { "name": "List", "slug": "list", "status": "active", "canonId": "019de52c-f94b-779b-a53b-fd4904a5f4d2", "version": 1, "description": "Bullet or numbered list." }, "tool": null, "subkind": { "name": "Bullet list", "slug": "bullet", "status": "active", "canonId": "019de52c-fc98-7169-a083-5cab805076ca", "version": 1, "description": null }, "framework": null }, "subkind": "bullet", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:18.475+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "599627ff-fbf8-484a-b372-11202b5f773d", "parentComponentId": null }, { "bbox": { "h": 0.03, "w": 0.86, "x": 0.07, "y": 0.48 }, "kind": "paragraph", "text": "Lavish treatment for a large number of surgeons and their entourages", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:18.475+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "754ef870-5217-4fbb-9f2b-10e3fd038651", "parentComponentId": null }, { "bbox": { "h": 0.15, "w": 0.86, "x": 0.07, "y": 0.19 }, "kind": "paragraph", "text": "The head of a major transplant program was astonished at the “eyebrow-raising” red-carpet treatment TransMedics provided to an estimated 150 to 200+ attendees at a “TransMedics-sponsored private event” – as well as to the entourages each doctor could bring.", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:18.475+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "fc69c4ba-c55c-488d-a83f-f646d8ffdc35", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "I will say the Boston trip was one of the nicest trips I’ve ever been invited to: first-class tickets, Boston Hotel Intercontinental. I was allowed to invite numerous members of my team, so I brought three additional members of my team, so there were four of us. That was the most generous that I’ve ever. I get invited with other companies, but this was very much a nicer experience. It was more like first-class tickets and whatnot. But doctors are not really accustomed to that in this day and age.. I fly economy all the time. I’m not accustomed - we’re not accustomed to that level of attention. ... it’s a little eyebrow raising, because devices are not as regulated as pharma now is. ... it was a really big group - I think there were about 200 surgeons from across the country. ... Yeah, they paid for Intercontinental Hotel. — Chief of transplant at a major West Cost center; high volume TransMedics user", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:07+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a97a-2facfe82d0c3", "parentComponentId": null }, { "bbox": { "h": 0.02, "w": 0.3, "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:18.475+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "5c4c9c40-63f2-4260-b633-3fd40224cfa8", "parentComponentId": null }, { "bbox": { "h": 0.12, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "title", "text": "The lack of Open Payments reporting is striking given what surgeons detailed as lavish, unusual travel inducements.", "attrs": null, "canon": { "kind": { "name": "Title", "slug": "title", "status": "active", "canonId": "019de52c-f7dd-76d9-b848-b1f12bd85cf4", "version": 1, "description": "Slide title or headline." }, "tool": null, "subkind": { "name": "Headline", "slug": "headline", "status": "active", "canonId": "019de52c-fae1-7463-9a7c-d60668eced0d", "version": 1, "description": null }, "framework": null }, "subkind": "headline", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:18.475+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "b6b6d72e-1ce8-4c02-bbe7-68ca8ba3830c", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [ { "matchId": "de5b61bb-151a-4a37-83aa-6d1ad34823fb", "evidence": "The slide explicitly contrasts company behavior with regulatory reporting requirements to imply wrongdoing.", "framework": null, "confidence": 0.9, "extraction": { "at": "2026-05-02 20:12:18.475+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 119, "frameworkName": "fraud-exposure" } ], "arcBeats": [], "loops": [], "locked": true }, { "page": 120, "type": "tension", "title": "The slide uses a quote to expose potential unethical vendor practices.", "function": "expose_contradiction", "rawType": "testimonial", "block": null, "metadata": { "slideType": "testimonial", "slideTypeCanon": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52d-0a2d-7782-8a48-7e84df92cc97", "version": 1, "description": null }, "function": "expose_contradiction", "functionCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-171f-776f-887c-73edaff4cf9c", "version": 1, "description": null }, "density": "balanced", "densityScore": 48, "componentCount": 5, "textChars": 2678, "nDataPoints": 0, "notes": "The slide uses a quote to expose potential unethical vendor practices.", "elementsJson": [ "paragraph", "quote_block", "footnote" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:12:19.827+00", "seconds": 4.469, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/120", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-120", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": { "h": 0.03, "w": 0.86, "x": 0.07, "y": 0.42 }, "kind": "callout", "text": "Persistent attempts to pay for travel and other expenses for transplant surgeons and administrators", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": null, "subkind": { "name": "Primary callout", "slug": "primary", "status": "active", "canonId": "019de52c-fbd1-70eb-a9ce-8997f8674c1d", "version": 1, "description": null }, "framework": null }, "subkind": "primary", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:19.827+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "d48824f6-df51-4296-b320-ebb7128c271f", "parentComponentId": null }, { "bbox": { "h": 0.25, "w": 0.86, "x": 0.07, "y": 0.45 }, "kind": "quote", "text": "“Yeah, I interacted with Waleed...they often invite us and all transplant programs that they work with to these meetings near their headquarters or whatever. Or they’ll have meetings at transplant conferences, and they’ll even offer to pay for us to go. I have to always turn it down because [our center] will not allow me to accept anything from a vendor but they do pay for other people to go. And so, I think I probably would interact with him more if I attended those meetings. But I don’t...I told them I’m not going to be at that meeting because I can’t travel right now. And they offered to reimburse me or pay for my commercial flight and registration for the meeting but I declined that. And then, they had the in-person meeting at their headquarters, and I declined the invitation because of the travel, and they offered again to pay for the cost of my travel ticket. It never got past that.” – Transplant administrator", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:19.827+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "f03a3fdc-478a-4a5a-9556-8b227cbc9bd4", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "“Yeah, I interacted with Waleed...they often invite us and all transplant programs that they work with to these meetings near their headquarters or whatever. Or they’ll have meetings at transplant conferences, and they’ll even offer to pay for us to go. I have to always turn it down because [our center] will not allow me to accept anything from a vendor but they do pay for other people to go. And so, I think I probably would interact with him more if I attended those meetings. But I don’t...I told them I’m not going to be at that meeting because I can’t travel right now. And they offered to reimburse me or pay for my commercial flight and registration for the meeting but I declined that. And then, they had the in-person meeting at their headquarters, and I declined the invitation because of the travel, and they offered again to pay for the cost of my travel ticket. It never got past that.” — Transplant administrator", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:08+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a97a-98d73f6089cc", "parentComponentId": null }, { "bbox": { "h": 0.02, "w": 0.25, "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:19.827+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "c37551f5-dcb7-4f38-9998-06b115507a34", "parentComponentId": null }, { "bbox": { "h": 0.28, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "title", "text": "Am executive at a pre-eminent academic transplant center, one of the highest volume in the world, described similar invitations from the CEO and persistent attempts to pay for flights, hotels, registration fees – all of which this transplant executive had to decline as it was inappropriate “to accept anything from a vendor”: “...I interacted with Waleed...they often invite us and all transplant programs...they’ll even offer to pay for us to go...I have to always turn it down....they do pay for other people to go...they offered to...pay for my commercial flights and registration...they offered again to pay for the cost of my travel...it never got past that.”", "attrs": null, "canon": { "kind": { "name": "Title", "slug": "title", "status": "active", "canonId": "019de52c-f7dd-76d9-b848-b1f12bd85cf4", "version": 1, "description": "Slide title or headline." }, "tool": null, "subkind": { "name": "Headline", "slug": "headline", "status": "active", "canonId": "019de52c-fae1-7463-9a7c-d60668eced0d", "version": 1, "description": null }, "framework": null }, "subkind": "headline", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:19.827+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "484c55fd-8d13-4817-b134-4ab6b7513106", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [], "arcBeats": [], "loops": [], "locked": true }, { "page": 121, "type": "tension", "title": "The slide uses a Q&A format to present expert testimony regarding alleged illegal business practices.", "function": "expose_contradiction", "rawType": "expose_contradiction", "block": null, "metadata": { "slideType": "expose_contradiction", "slideTypeCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-124c-75aa-984a-0a3d0d8fc8df", "version": 1, "description": null }, "function": "expose_contradiction", "functionCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-171f-776f-887c-73edaff4cf9c", "version": 1, "description": null }, "density": "dense", "densityScore": 64, "componentCount": 7, "textChars": 3586, "nDataPoints": 0, "notes": "The slide uses a Q&A format to present expert testimony regarding alleged illegal business practices.", "elementsJson": [ "paragraph", "quote_block" ], "confidence": 0.95, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:12:19.507+00", "seconds": 4.082, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/121", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-121", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": { "h": 0.03, "w": 0.86, "x": 0.07, "y": 0.48 }, "kind": "callout", "text": "Trinity Air allegedly engaging in abusive business practices similar to TransMedics", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": null, "subkind": { "name": "Primary callout", "slug": "primary", "status": "active", "canonId": "019de52c-fbd1-70eb-a9ce-8997f8674c1d", "version": 1, "description": null }, "framework": null }, "subkind": "primary", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:19.507+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "1309c9d4-8176-4a44-a5d2-d721205c53c0", "parentComponentId": null }, { "bbox": null, "kind": "callout", "text": "The CEO alleged practices almost identical to those indicated by ex-TransMedics employees: “they’ll fly planes in from like Arizona and to do stuff in New York because they can charge for all that...they’ll also pay the transplant program or pay somebody, whoever makes the decisions...they’ll give them a kickback to use their transplant logistics services even though they’re excessively more expensive...because whoever makes the decision is getting a piece of that.”", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:08+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a97a-ad130ca4e660", "parentComponentId": null }, { "bbox": { "h": 0.38, "w": 0.86, "x": 0.07, "y": 0.52 }, "kind": "list", "text": "Q: “A former employee told me that even if they have a team that’s based in a metro area, they will often fly in a jet from the other end of the country, and the staff is like, “What are you doing? We’re already here.” I presume the reason is because then they get to bill all that?” A: “Yeah, and if you’ve heard of Trinity Air Medical, which is owned by Blade? Blade bought Trinity for $22 million and it does $110 million now. But that’s what they do. They don’t know it, but they’re under a federal investigation, and Blade’s only doing what it’s doing because of Trinity. But Trinity is under investigation. I don’t know if they even know it. But they’re giving kickbacks to different transplant programs in New York, like, hey, transplant administrator; I’ll kick you x amount of dollars, you just keep calling us, but that’s why the DOJ in New York has tuned in because they’re primarily based on New York. So, Blade’s getting in trouble...they’re about to get kicked in the teeth.” Q: “So, Trinity, they’re giving kickbacks to people to use their service even if a plane is not necessary?” A: “Yeah, they’ll fly planes in from like Arizona to do stuff in New York because they can charge for all that, but then they’ll also pay the transplant program or pay somebody, whoever makes the decisions, they’ll give them a kickback to use their transplant logistics services even though they’re excessively more expensive than other people, but they’ll keep calling and using Trinity because whoever makes the decision is getting a piece of that.” - CEO of a major OPO (Organ Procurement Organization), longtime industry executive", "attrs": null, "canon": { "kind": { "name": "List", "slug": "list", "status": "active", "canonId": "019de52c-f94b-779b-a53b-fd4904a5f4d2", "version": 1, "description": "Bullet or numbered list." }, "tool": null, "subkind": { "name": "Bullet list", "slug": "bullet", "status": "active", "canonId": "019de52c-fc98-7169-a083-5cab805076ca", "version": 1, "description": null }, "framework": null }, "subkind": "bullet", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:19.507+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "e170c6e9-dcde-4721-9238-c5f899bedac0", "parentComponentId": null }, { "bbox": { "h": 0.25, "w": 0.86, "x": 0.07, "y": 0.22 }, "kind": "paragraph", "text": "The CEO of a major organ procurement organization (OPO) alleged that Trinity Air Medical, owned by Blade Air Mobility (NASDAQ: BLDE) since 2021, is “under a federal investigation” for “giving kickbacks to different transplant programs...Blade’s getting into trouble...they’re about to get kicked in the teeth.” The CEO alleged practices almost identical to those indicated by ex-TransMedics employees: “they’ll fly planes in from like Arizona and to do stuff in New York because they can charge for all that...they’ll also pay the transplant program or pay somebody, whoever makes the decisions...they’ll give them a kickback to use their transplant logistics services even though they’re excessively more expensive...because whoever makes the decision is getting a piece of that.” We note that the color above re Trinity is merely allegation and that we have not verified its accuracy.", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:19.507+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "f33ec97c-9f63-49de-80ef-1bec058d69a5", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "“they’re under a federal investigation” for “giving kickbacks to different transplant programs...Blade’s getting into trouble...they’re about to get kicked in the teeth.” — CEO of a major OPO (Organ Procurement Organization), longtime industry executive", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:08+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a97a-b083848c4367", "parentComponentId": null }, { "bbox": { "h": 0.02, "w": 0.3, "x": 0.07, "y": 0.92 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:19.507+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "ef5947dd-e7ef-47c5-888b-059aa54e9df3", "parentComponentId": null }, { "bbox": { "h": 0.15, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "title", "text": "TransMedics aircraft-based business model is inherently high risk and prone to abuse and potential kickbacks, given similar alleged business practices at its competitors in the organ air transport industry.", "attrs": null, "canon": { "kind": { "name": "Title", "slug": "title", "status": "active", "canonId": "019de52c-f7dd-76d9-b848-b1f12bd85cf4", "version": 1, "description": "Slide title or headline." }, "tool": null, "subkind": { "name": "Headline", "slug": "headline", "status": "active", "canonId": "019de52c-fae1-7463-9a7c-d60668eced0d", "version": 1, "description": null }, "framework": null }, "subkind": "headline", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:19.507+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "c0922c98-b045-48c5-9c41-5a32642b45f8", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [], "arcBeats": [], "loops": [], "locked": true }, { "page": 122, "type": "tension", "title": "The slide uses a Q&A transcript format to substantiate claims of industry-wide corruption and ongoing investigations.", "function": "expose_contradiction", "rawType": "expose_contradiction", "block": null, "metadata": { "slideType": "expose_contradiction", "slideTypeCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-124c-75aa-984a-0a3d0d8fc8df", "version": 1, "description": null }, "function": "expose_contradiction", "functionCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-171f-776f-887c-73edaff4cf9c", "version": 1, "description": null }, "density": "balanced", "densityScore": 46, "componentCount": 5, "textChars": 2182, "nDataPoints": 0, "notes": "The slide uses a Q&A transcript format to substantiate claims of industry-wide corruption and ongoing investigations.", "elementsJson": [ "paragraph", "quote_block", "footnote" ], "confidence": 0.95, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:12:18.847+00", "seconds": 3.349, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/122", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-122", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "The CEO of the OPO alleged that Trinity Air Medical is under investigation by the DOJ, and that it is an open secret in the industry given the large number of industry participants such as other OPO's who have been interviewed as part of an alleged investigation.", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:08+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a97a-d57c9b4b3317", "parentComponentId": null }, { "bbox": { "h": 0.25, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "paragraph", "text": "The CEO of the OPO alleged that Trinity Air Medical is under investigation by the DOJ, and that it is an open secret in the industry given the large number of industry participants such as other OPO's who have been interviewed as part of an alleged investigation: “it’s probably that well-kept of a secret at this point...all those people have been interviewed....” He further suggested that NORA – the Nationwide Organ Recovery Transport Alliance – engages in similar practices to Trinity and TransMedics, portraying the entire organ transport industry as inherently corrupt.", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:18.847+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "40c91321-5d9d-4bab-8fdc-70eea94e3f9a", "parentComponentId": null }, { "bbox": { "h": 0.45, "w": 0.86, "x": 0.07, "y": 0.38 }, "kind": "paragraph", "text": "Trinity allegedly under DOJ investigation\nQ: “How does Trinity give a piece to the transplant administrator?”\nA: “I don’t know what the mechanism is, but the DOJ is investigating it.”\nQ: “Is that public? Is that known that Trinity is under investigation?”\nA: “No. I mean, I don’t think it’s probably that well-kept of a secret at this point.”\nQ: “And so, who talks about it? Do heads of OPO’s all know that Trinity - I mean, they probably subpoenaed people, people have been interviewed—is that how people know about it?”\nA: “Yeah, all those people have been interviewed. There’s enough people at this point.”\nQ: “Is Trinity part of this Washington Post article, this big investigation that you mentioned?”\nQ: “If Trinity is doing this, my assumption is there’s no way that TransMedics NOP is not. It’s the exact same business.”\nA: “That’s what I would think. I would think the same thing, and then NORA is the other major logistics provider, and they’ve offered me private flights, and I’m like, “No, I’m not doing it.” - CEO of a major OPO (Organ Procurement Organization), longtime industry executive", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:18.847+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "8c980ab8-37bd-4481-bb56-a70383c058ab", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "“it’s probably that well-kept of a secret at this point...all those people have been interviewed....” — CEO of a major OPO (Organ Procurement Organization), longtime industry executive", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:08+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a97a-dac01edd6aa5", "parentComponentId": null }, { "bbox": { "h": 0.02, "w": 0.25, "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:18.847+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "9618b750-ae3d-40b6-8d53-03c76ed07024", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [ { "matchId": "705d5dfe-342b-4755-854a-489f41e7bff4", "evidence": "The slide presents allegations of corruption and investigation to contrast with the public perception of the industry.", "framework": null, "confidence": 0.8, "extraction": { "at": "2026-05-02 20:12:18.847+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 122, "frameworkName": "expose_contradiction" } ], "arcBeats": [], "loops": [], "locked": true }, { "page": 123, "type": "tension", "title": "The slide uses a Q&A transcript format to substantiate claims of kickbacks in the organ transport industry.", "function": "expose_contradiction", "rawType": "expose_contradiction", "block": null, "metadata": { "slideType": "expose_contradiction", "slideTypeCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-124c-75aa-984a-0a3d0d8fc8df", "version": 1, "description": null }, "function": "expose_contradiction", "functionCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-171f-776f-887c-73edaff4cf9c", "version": 1, "description": null }, "density": "balanced", "densityScore": 37, "componentCount": 6, "textChars": 1016, "nDataPoints": 0, "notes": "The slide uses a Q&A transcript format to substantiate claims of kickbacks in the organ transport industry.", "elementsJson": [ "paragraph", "quote_block", "footnote" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:12:20.831+00", "seconds": 5.318, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/123", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-123", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "Confirming our suspicion about the potential to use TransMedics jets for free private air travel as a kickback or inducement, the CEO of the OPO recounted anecdotes of such offers from Trinity and NORA.", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:08+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a97b-0637ca9534f8", "parentComponentId": null }, { "bbox": { "h": 0.38, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "paragraph", "text": "Confirming our suspicion about the potential to use TransMedics jets for free private air travel as a kickback or inducement, the CEO of the OPO recounted anecdotes of such offers from Trinity and NORA...", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:20.831+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "149e8ddf-4548-4d09-bce2-00326bf1a293", "parentComponentId": null }, { "bbox": { "h": 0.38, "w": 0.86, "x": 0.07, "y": 0.52 }, "kind": "paragraph", "text": "Q: \"You just said something that confirms a major hunch to me...\" A: \"The rumor is that Trinity does that... NORA offered me stuff...\"", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:20.831+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "fc7380e2-5533-4534-a733-88bd436da2e0", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "“The Trinity thing is well known. The NORA thing, I don’t think it’s as well-known, but I was at a meeting in Boston, and I made the comment, I’m like, ‘Yeah, they offered me a private flight,’ and the woman sitting across from me was like, ‘Yeah, they did it to me, too.’ We both kind of laughed about it.” — CEO of a major OPO (Organ Procurement Organization)", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:08+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a97b-0b079b0dd234", "parentComponentId": null }, { "bbox": { "h": 0.02, "w": 0.3, "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:20.831+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "ceffce35-5b56-43b6-b627-dae5b929e113", "parentComponentId": null }, { "bbox": { "h": 0.03, "w": 0.45, "x": 0.07, "y": 0.48 }, "kind": "title", "text": "Trinity and NORA allegedly offering free private air travel", "attrs": null, "canon": { "kind": { "name": "Title", "slug": "title", "status": "active", "canonId": "019de52c-f7dd-76d9-b848-b1f12bd85cf4", "version": 1, "description": "Slide title or headline." }, "tool": null, "subkind": { "name": "Headline", "slug": "headline", "status": "active", "canonId": "019de52c-fae1-7463-9a7c-d60668eced0d", "version": 1, "description": null }, "framework": null }, "subkind": "headline", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:20.831+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "8dc4347b-e8eb-4240-a4b8-93e760555800", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [], "arcBeats": [], "loops": [], "locked": true }, { "page": 124, "type": "tension", "title": "This slide serves as a transition or section header for a highly critical argument against the company.", "function": "name_villain", "rawType": "villain_critique", "block": null, "metadata": { "slideType": "villain_critique", "slideTypeCanon": { "name": "Villain critique", "slug": "villain_critique", "status": "active", "canonId": "019de52d-10bc-7136-bf20-09de59d17447", "version": 1, "description": null }, "function": "name_villain", "functionCanon": { "name": "Name villain", "slug": "name_villain", "status": "active", "canonId": "019de52d-1746-70d6-bc58-5eeaf5865526", "version": 1, "description": null }, "density": "sparse", "densityScore": 9, "componentCount": 2, "textChars": 398, "nDataPoints": 0, "notes": "This slide serves as a transition or section header for a highly critical argument against the company.", "elementsJson": [ "paragraph" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:12:19.356+00", "seconds": 3.805, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/124", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-124", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "We believe TransMedics is operating an organ trafficking scheme, shopping and steering rejected organs to its top users as a quid pro quo for accepting them on its device and via its NOP service.", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:08+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a97a-6c82e9cbe23d", "parentComponentId": null }, { "bbox": { "h": 0.153, "w": 0.854, "x": 0.073, "y": 0.069 }, "kind": "title", "text": "Part 5. We believe TransMedics is operating an organ trafficking scheme, shopping and steering rejected organs to its top users as a quid pro quo for accepting them on its device and via its NOP service.", "attrs": null, "canon": { "kind": { "name": "Title", "slug": "title", "status": "active", "canonId": "019de52c-f7dd-76d9-b848-b1f12bd85cf4", "version": 1, "description": "Slide title or headline." }, "tool": null, "subkind": { "name": "Headline", "slug": "headline", "status": "active", "canonId": "019de52c-fae1-7463-9a7c-d60668eced0d", "version": 1, "description": null }, "framework": null }, "subkind": "headline", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:19.356+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "e9875a09-f6b3-4b31-9363-375af3dc087d", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [], "arcBeats": [], "loops": [], "locked": true }, { "page": 125, "type": "tension", "title": "The slide uses a legal statute to frame the company's business model as criminal activity.", "function": "name_villain", "rawType": "villain_critique", "block": null, "metadata": { "slideType": "villain_critique", "slideTypeCanon": { "name": "Villain critique", "slug": "villain_critique", "status": "active", "canonId": "019de52d-10bc-7136-bf20-09de59d17447", "version": 1, "description": null }, "function": "name_villain", "functionCanon": { "name": "Name villain", "slug": "name_villain", "status": "active", "canonId": "019de52d-1746-70d6-bc58-5eeaf5865526", "version": 1, "description": null }, "density": "dense", "densityScore": 66, "componentCount": 8, "textChars": 1911, "nDataPoints": 0, "notes": "The slide uses a legal statute to frame the company's business model as criminal activity.", "elementsJson": [ "paragraph", "callout_box" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:12:19.034+00", "seconds": 2.975, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/125", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-125", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "We conclude, based on extensive research, that TransMedics is engaging in a sinister scheme whereby organs are illegally steered to centers under the implicit or explicit quid pro quo that a) they accept the organ on its device and b) that it is transported via its NOP service on its private jets.", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:08+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a97a-c11d962f28ba", "parentComponentId": null }, { "bbox": { "h": 0.13, "w": 0.86, "x": 0.07, "y": 0.61 }, "kind": "paragraph", "text": "(a) PROHIBITION\nIt shall be unlawful for any person to knowingly acquire, receive, or otherwise transfer any human organ for valuable consideration for use in human transplantation if the transfer affects interstate commerce. The preceding sentence does not apply with respect to human organ paired donation.", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:19.034+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "9b818f78-b27f-45b9-9a37-138a3c7c1769", "parentComponentId": null }, { "bbox": { "h": 0.07, "w": 0.86, "x": 0.07, "y": 0.83 }, "kind": "paragraph", "text": "(b) PENALTIES\nAny person who violates subsection (a) shall be fined not more than $50,000 or imprisoned not more than five years, or both.", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:19.034+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "ba31e5ac-2666-4970-86a1-96556e72449e", "parentComponentId": null }, { "bbox": { "h": 0.35, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "paragraph", "text": "We conclude, based on extensive research, that TransMedics is engaging in a sinister scheme whereby organs are illegally steered to centers under the implicit or explicit quid pro quo that a) they accept the organ on its device and b) it is transported via its NOP service on its private jets. The organ, we believe, therefore constitutes a kickback under the Anti-Kickback Statute (“Stark Law”) and also, in our opinion, meets the legal definition of organ trafficking per the National Organ Transplant Act which makes it unlawful to “acquire, receive, or transfer any human organ for valuable consideration” – under penalty of fines and/or imprisonment; and per international conventions, such as the Istanbul Declaration and others.", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:19.034+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "c0fbba56-0c50-46fb-b293-0765adcf9e01", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "It shall be unlawful for any person to knowingly acquire, receive, or otherwise transfer any human organ for valuable consideration for use in human transplantation if the transfer affects interstate commerce. — 42 U.S. Code § 274e", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:08+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a97a-c4ac7932ce60", "parentComponentId": null }, { "bbox": { "h": 0.02, "w": 0.5, "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts; https://www.law.cornell.edu/uscode/text/42/274e", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:19.034+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "d0e098e9-4b17-42aa-a07a-09151e6df9a3", "parentComponentId": null }, { "bbox": { "h": 0.09, "w": 0.86, "x": 0.07, "y": 0.49 }, "kind": "title", "text": "42 U.S. Code § 274e - Prohibition of organ purchases", "attrs": null, "canon": { "kind": { "name": "Title", "slug": "title", "status": "active", "canonId": "019de52c-f7dd-76d9-b848-b1f12bd85cf4", "version": 1, "description": "Slide title or headline." }, "tool": null, "subkind": { "name": "Headline", "slug": "headline", "status": "active", "canonId": "019de52c-fae1-7463-9a7c-d60668eced0d", "version": 1, "description": null }, "framework": null }, "subkind": "headline", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:19.034+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "16c5040d-3ae6-4b7d-9fb8-60b4fcd786c6", "parentComponentId": null }, { "bbox": { "h": 0.03, "w": 0.45, "x": 0.07, "y": 0.44 }, "kind": "title", "text": "National Organ Transplant Act of 1984 (NOTA)", "attrs": null, "canon": { "kind": { "name": "Title", "slug": "title", "status": "active", "canonId": "019de52c-f7dd-76d9-b848-b1f12bd85cf4", "version": 1, "description": "Slide title or headline." }, "tool": null, "subkind": { "name": "Headline", "slug": "headline", "status": "active", "canonId": "019de52c-fae1-7463-9a7c-d60668eced0d", "version": 1, "description": null }, "framework": null }, "subkind": "headline", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:19.034+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "3fd3cc39-2606-4839-96b0-b4416e4556f1", "parentComponentId": null } ], "metrics": [], "tools": [ { "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null, "categoryName": null, "categorySlug": null }, "agent": null, "layer": "slide", "agents": null, "matchId": "2ec0256c-6995-4832-8156-365997bc8e5b", "evidence": "The reference to the National Organ Transplant Act of 1984 (NOTA) provides a legal basis for the accusations.", "pageRefs": null, "priority": null, "whenToUse": null, "confidence": 0.8, "extraction": { "at": "2026-07-16 23:10:32.233402+00", "model": "or:meta-llama/llama-4-scout", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 125, "whyItWorks": null, "antipattern": null, "cardinality": "common", "narrativePurpose": null } ], "frameworks": [], "arcBeats": [], "loops": [], "locked": true }, { "page": 126, "type": "tension", "title": "The slide uses a narrative structure to explain a systemic loophole, supported by a direct excerpt from an official policy document.", "function": "expose_contradiction", "rawType": "expose_contradiction", "block": null, "metadata": { "slideType": "expose_contradiction", "slideTypeCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-124c-75aa-984a-0a3d0d8fc8df", "version": 1, "description": null }, "function": "expose_contradiction", "functionCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-171f-776f-887c-73edaff4cf9c", "version": 1, "description": null }, "density": "balanced", "densityScore": 48, "componentCount": 6, "textChars": 1726, "nDataPoints": 0, "notes": "The slide uses a narrative structure to explain a systemic loophole, supported by a direct excerpt from an official policy document.", "elementsJson": [ "paragraph", "screenshot" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:12:19.886+00", "seconds": 3.407, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/126", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-126", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": { "h": 0.25, "w": 0.41, "x": 0.52, "y": 0.65 }, "kind": "callout", "text": "Excerpt of policy change - criteria under which expedited organ offers can be made", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": null, "subkind": { "name": "Primary callout", "slug": "primary", "status": "active", "canonId": "019de52c-fbd1-70eb-a9ce-8997f8674c1d", "version": 1, "description": null }, "framework": null }, "subkind": "primary", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:19.886+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "5b0cbb39-f6be-4c0b-9e96-a7b4c22b3a4e", "parentComponentId": null }, { "bbox": null, "kind": "callout", "text": "TransMedics and/or OPO's with whom it conspires allegedly start “dialing for dollars,” according to ex-employees and others, to offer the organ to centers willing to accept it with the understanding that it comes on a TransMedics pump and on its NOP aircraft.", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:08+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a97b-1cd3bfd32c02", "parentComponentId": null }, { "bbox": { "h": 0.25, "w": 0.45, "x": 0.07, "y": 0.63 }, "kind": "image", "text": "OPTN Notice of OPTN Policy Change Expedited Placement of Livers", "attrs": null, "canon": { "kind": { "name": "Image", "slug": "image", "status": "active", "canonId": "019de52c-f978-701f-a720-51d029d769e7", "version": 1, "description": "Photo, illustration, screenshot or icon." }, "tool": null, "subkind": { "name": "Screenshot", "slug": "screenshot", "status": "active", "canonId": "019de52c-fd87-7509-8391-3d79fb339379", "version": 1, "description": null }, "framework": null }, "subkind": "screenshot", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:19.886+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "8c5bc5af-7818-48aa-b5ec-e05f7fab1673", "parentComponentId": null }, { "bbox": { "h": 0.45, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "paragraph", "text": "The full extent of the scheme became clear across interviews with ex-employees, transplant surgeons, and OPO’s: 1) TransMedics organ procurement team arrives for a retrieval; 2) the first center on the UNOS/OPTN transplant waiting list declines the organ, typically because it is old, defective, or otherwise compromised; 3) the organ is then classified as an “Expedited Offer,” a loophole in the OPTN organ allocation system which is now routinely abused to bypass the waiting list and preferentially steer the organ; 4) TransMedics and/or OPO’s with whom it conspires allegedly start “dialing for dollars,” according to ex-employees and others, to offer the organ to centers willing to accept it with the understanding that it comes on a TransMedics pump and on its NOP aircraft – unsurprisingly, its highest-volume and most corrupt customers seem to get the call. OPTN instituted expedited placement rules in March 2021, with criteria to prevent a “jump ball” when the first center declines an organ – a well-meaning rule that backfired by providing an official pretext for rampant abuses.", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:19.886+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "8b7c2a7d-1a8d-429a-b2fd-65bfee0738fc", "parentComponentId": null }, { "bbox": { "h": 0.03, "w": 0.7, "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts; https://optn.transplant.hrsa.gov/media/3451/expedited-placement-of-livers-policy-notice.pdf", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:19.886+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "987aa75b-fbef-4fc0-a4ed-54c4793c927f", "parentComponentId": null }, { "bbox": { "h": 0.03, "w": 0.45, "x": 0.07, "y": 0.58 }, "kind": "source-note", "text": "OPTN Notice of Policy Change for expedited organ offers, effective March 25, 2021", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:19.886+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "f723e118-7274-45f8-909a-53cd142d9a43", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [], "arcBeats": [], "loops": [], "locked": true }, { "page": 127, "type": "tension", "title": "The slide uses a combination of narrative summary and direct excerpts from a Feb 2024 letter to expose flaws in the OPTN allocation system.", "function": "expose_contradiction", "rawType": "expose_contradiction", "block": null, "metadata": { "slideType": "expose_contradiction", "slideTypeCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-124c-75aa-984a-0a3d0d8fc8df", "version": 1, "description": null }, "function": "expose_contradiction", "functionCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-171f-776f-887c-73edaff4cf9c", "version": 1, "description": null }, "density": "dense", "densityScore": 70, "componentCount": 8, "textChars": 2663, "nDataPoints": 0, "notes": "The slide uses a combination of narrative summary and direct excerpts from a Feb 2024 letter to expose flaws in the OPTN allocation system.", "elementsJson": [ "paragraph", "quote_block", "footnote" ], "confidence": 0.95, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:12:20.268+00", "seconds": 3.376, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/127", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-127", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "The growth in these types of workarounds (system violations, at present) strongly suggests that the current allocation system is not optimized to efficiently match organs with a patient", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-23 01:18:10+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-70f3-714d-84bf-fe3f4f5aa0c7", "parentComponentId": null }, { "bbox": { "h": 0.15, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "paragraph", "text": "Transplant centers recognize that expedited placement has devolved into the Wild West, with OPTN now proposing reforms for “Expedited Placement Variance” – a euphemism for rampant out-of-sequence organ placement, favoritism, secrecy, and misuse.", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:20.268+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "3e43c499-d420-4875-9ac1-a5958fcab0f4", "parentComponentId": null }, { "bbox": { "h": 0.22, "w": 0.86, "x": 0.07, "y": 0.68 }, "kind": "paragraph", "text": "it takes for an OPO to progress through the match run to place a kidney. Recently, there has been an increase in out-of-sequence offers, “open offers,” and similar workarounds to the pilots are made permanent in various regions, a patchwork of opaque organ allocation practices that are not transparent to patients or the community at large could arise, exacerbating existing are at a transplant center that is not favored as an aggressive center worthy of being offered certain organs by the participating OPO. While aspects of this inequitable dynamic exist in our", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:20.268+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "60cf1c86-0e92-41bd-8f57-dc375e29edec", "parentComponentId": null }, { "bbox": { "h": 0.25, "w": 0.86, "x": 0.07, "y": 0.22 }, "kind": "paragraph", "text": "In Feb 2024, the American Society of Nephrology detailed its concerns in a 12-page letter to OPTN and HHS. The language is watered-down but spotlights the abuses: “systems violations”; “an increase in out-of-sequence offers, ‘open offers,’ and similar workarounds to the allocation system”; “a patchwork of opaque organ allocation practices”; patients are not “getting a fair opportunity” for an organ if they are at a center that is “not favored as an aggressive center by the participating OPO”; and that not a single OPO or transplant center has been “held accountable for any violation” of match rules.", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:20.268+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "8bfa1e13-2f55-4649-b629-a8474c8c6e89", "parentComponentId": null }, { "bbox": { "h": 0.15, "w": 0.86, "x": 0.07, "y": 0.52 }, "kind": "paragraph", "text": "The growth in these types of workarounds (system violations, at present) strongly suggests that the current allocation system is not optimized to efficiently match organs with a patient and a consider expanding expedited placement practices. The current match-run algorithm, in apparently a growing number of cases, does not make match suggestions that the dedicated professionals at OPOs or transplant centers have confidence in.", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:20.268+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "f9f86a20-b444-444b-a372-296bab9e6ee8", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "“systems violations”; “an increase in out-of-sequence offers, ‘open offers,’ and similar workarounds to the allocation system”; “a patchwork of opaque organ allocation practices”; patients are not “getting a fair opportunity” for an organ if they are at a center that is “not favored as an aggressive center by the participating OPO”; and that not a single OPO or transplant center has been “held accountable for any violation” of match rules. — American Society of Nephrology letter to OPTN/HHS, Feb 2024", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-23 01:18:10+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-70f3-714d-84c0-0211475ac1a0", "parentComponentId": null }, { "bbox": { "h": 0.02, "w": 0.3, "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:20.268+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "c427064f-f5db-414d-985e-55cce5bb0f81", "parentComponentId": null }, { "bbox": { "h": 0.03, "w": 0.5, "x": 0.07, "y": 0.48 }, "kind": "title", "text": "American Society of Nephrology letter to OPTN/HSS, Feb 2024 - excerpts", "attrs": null, "canon": { "kind": { "name": "Title", "slug": "title", "status": "active", "canonId": "019de52c-f7dd-76d9-b848-b1f12bd85cf4", "version": 1, "description": "Slide title or headline." }, "tool": null, "subkind": { "name": "Subtitle", "slug": "subtitle", "status": "active", "canonId": "019de52c-fb09-739d-900c-815b0d9ac526", "version": 1, "description": null }, "framework": null }, "subkind": "subtitle", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:20.268+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "d0b99036-8223-489a-9bba-2036f447ecfe", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [], "arcBeats": [], "loops": [], "locked": true }, { "page": 128, "type": "tension", "title": "The slide presents anecdotal evidence of systemic gaming of the organ allocation system.", "function": "expose_contradiction", "rawType": "expose_contradiction", "block": null, "metadata": { "slideType": "expose_contradiction", "slideTypeCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-124c-75aa-984a-0a3d0d8fc8df", "version": 1, "description": null }, "function": "expose_contradiction", "functionCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-171f-776f-887c-73edaff4cf9c", "version": 1, "description": null }, "density": "dense", "densityScore": 55, "componentCount": 6, "textChars": 3284, "nDataPoints": 0, "notes": "The slide presents anecdotal evidence of systemic gaming of the organ allocation system.", "elementsJson": [ "paragraph", "quote_block", "footnote" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:12:21.64+00", "seconds": 4.73, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/128", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-128", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": { "h": 0.03, "w": 0.86, "x": 0.07, "y": 0.59 }, "kind": "callout", "text": "Suspicious practices and “workarounds” in organ allocation; “lot of game playing”", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": null, "subkind": { "name": "Primary callout", "slug": "primary", "status": "active", "canonId": "019de52c-fbd1-70eb-a9ce-8997f8674c1d", "version": 1, "description": null }, "framework": null }, "subkind": "primary", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:21.64+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "29a75557-d0b2-426f-93ff-a6b9f17abeea", "parentComponentId": null }, { "bbox": null, "kind": "callout", "text": "There’s a lot of game-playing going on out there.", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:08+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a97a-7ea324435ccd", "parentComponentId": null }, { "bbox": { "h": 0.45, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "paragraph", "text": "We spoke with surgeons who we believe participate in the scheme and unwittingly let us in on the details, as well as surgeons who have long suspected something improper but were unable to form a complete picture of its mechanics. We probed a transplant hepatologist at Massachusetts General, who seemed to leap out of his chair when we shared some of our findings, as the color appeared to confirm his worst suspicions and help crystallize his own observations: “if that get’s revealed, if that gets exposed in any way, that’s curtains...I have known of some sites in our region that would get these kinds of calls...other regions...this kind of hotline for organs that were turned down...this kind of workaround...it allowed them consequently to boost their numbers substantially in a given year with these organs...we scratch our heads wondering how in the heck did these guys get these organs? How did that happen? That’s not what ought to be happening through our new allocation system...there’s a lot of game playing going on out there.”", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:21.64+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "e8d03c3b-2cda-4334-a3a6-3063a3023330", "parentComponentId": null }, { "bbox": { "h": 0.28, "w": 0.86, "x": 0.07, "y": 0.63 }, "kind": "quote", "text": "Q: “I’m hearing that if the recipient center doesn’t want the organ, TransMedics, according to a surgeon at a major center, who said, yeah, there are clinical guys badgering me to take a liver I don’t want to take. And it appears they’re then basically circumventing the OPO and the whole allocation algorithm, and they’re calling around for somebody that’s willing to take the organ, and, of course, they’re only calling people that are going to take it on a TransMedics device. So, they’re calling their highest-volume users.” A: “If that gets revealed, if that gets exposed in any way, that’s curtains. It’s really interesting you bring that up because I have known of some sites in our region that would get these kinds of calls from other sites, other regions, and would have this kind of hotline for organs that were turned down...it was this kind of workaround, this shunt that found its way to the center and it allowed them consequently to boost their numbers substantially in a given year with these organs. We scratch our heads wondering how in the heck did these guys get these organs? How did that happen? That’s not what ought to be happening through our new allocation system. Those organs should still be offered to other regions’ highest-priority patients who haven’t yet received offers. There’s a lot of game-playing going on out there.” – Transplant hepatologist at Massachusetts General Hospital", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:21.64+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "6f4634c8-d54c-4f1d-8780-3345ef73600f", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "“if that get’s revealed, if that gets exposed in any way, that’s curtains...I have known of some sites in our region that would get these kinds of calls...other regions...this kind of hotline for organs that were turned down...this kind of workaround...it allowed them consequently to boost their numbers substantially in a given year with these organs...we scratch our heads wondering how in the heck did these guys get these organs? How did that happen? That’s not what ought to be happening through our new allocation system...there’s a lot of game playing going on out there.” — Transplant hepatologist at Massachusetts General Hospital", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:08+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a97a-82adbb35389e", "parentComponentId": null }, { "bbox": { "h": 0.02, "w": 0.25, "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:21.64+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "a643153e-a826-412a-8996-aebda80b01d2", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [], "arcBeats": [], "loops": [], "locked": true }, { "page": 129, "type": "tension", "title": "The slide uses a direct quote from a transplant surgeon to allege systemic gaming of the organ allocation system.", "function": "expose_contradiction", "rawType": "quote_slide", "block": null, "metadata": { "slideType": "quote_slide", "slideTypeCanon": { "name": "Quote slide", "slug": "quote_slide", "status": "active", "canonId": "019de52d-098e-7555-a9fd-4f0af7e80bc2", "version": 1, "description": null }, "function": "expose_contradiction", "functionCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-171f-776f-887c-73edaff4cf9c", "version": 1, "description": null }, "density": "balanced", "densityScore": 42, "componentCount": 5, "textChars": 1619, "nDataPoints": 0, "notes": "The slide uses a direct quote from a transplant surgeon to allege systemic gaming of the organ allocation system.", "elementsJson": [ "paragraph", "quote_block" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:12:22.095+00", "seconds": 4.822, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/129", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-129", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "The physician described how unscrupulous centers are boosting their organ volumes via suspicious “hotlines” coming from certain areas like Tennessee – basically a gray or black market for livers.", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:08+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a97b-731bd03e5da8", "parentComponentId": null }, { "bbox": { "h": 0.45, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "paragraph", "text": "The physician described how unscrupulous centers are boosting their organ volumes via suspicious “hotlines” coming from certain areas like Tennessee – basically a gray or black market for livers...", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:22.095+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "e46ad9a4-1f03-41dd-81ac-909c7ed3fc16", "parentComponentId": null }, { "bbox": { "h": 0.25, "w": 0.86, "x": 0.07, "y": 0.55 }, "kind": "quote", "text": "Oh yeah. These are centers where we heard that they got organs from out of region... it just stopped being part of the formal allocation process. This kind of thing, I suspect, is actually happening much more frequently than we know.", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:22.095+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "dcae2ca7-90a9-443e-b2d9-0cf63031ce05", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "“Oh yeah. These are centers where we heard that they got organs from out of region and they would seem to come from a similar kind of procurement area. Like they would come from, say, Tennessee or something. And there would be literally a sort of hotline from the procuring team there to this center in our region asking if they want an organ...the fact was these guys were clearly getting them not in a sequential orderly way that would have put them next up for that organ, but rather there were local turndowns by local recipient centers and then all of a sudden it became this kind of free for all. And so, it never diverted effectively; it just stopped being part of the formal allocation process. This kind of thing, I suspect, is actually happening much more frequently than we know...I think this is how some centers get ahead in their numbers. It’s a below the radar screen kind of arrangement.” — Transplant surgeon, Utah center", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:08+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a97b-76bde5475b56", "parentComponentId": null }, { "bbox": { "h": 0.02, "w": 0.3, "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:22.095+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "48bf99ce-2c0a-42be-86b3-5a9fe3fab5bc", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [], "arcBeats": [], "loops": [], "locked": true }, { "page": 130, "type": "tension", "title": "Includes direct quotes from a transplant hepatologist at Mass General Hospital to support the thesis of perverse incentives.", "function": "name_villain", "rawType": "villain_critique", "block": null, "metadata": { "slideType": "villain_critique", "slideTypeCanon": { "name": "Villain critique", "slug": "villain_critique", "status": "active", "canonId": "019de52d-10bc-7136-bf20-09de59d17447", "version": 1, "description": null }, "function": "name_villain", "functionCanon": { "name": "Name villain", "slug": "name_villain", "status": "active", "canonId": "019de52d-1746-70d6-bc58-5eeaf5865526", "version": 1, "description": null }, "density": "overcrowded", "densityScore": 85, "componentCount": 10, "textChars": 4216, "nDataPoints": 0, "notes": "Includes direct quotes from a transplant hepatologist at Mass General Hospital to support the thesis of perverse incentives.", "elementsJson": [ "paragraph", "quote_block" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:12:23.474+00", "seconds": 6.18, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/130", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-130", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": { "h": 0.03, "w": 0.86, "x": 0.07, "y": 0.56 }, "kind": "callout", "text": "Perverse incentive for smaller centers desperate for volume to accept organs on TransMedics pump", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": null, "subkind": { "name": "Primary callout", "slug": "primary", "status": "active", "canonId": "019de52c-fbd1-70eb-a9ce-8997f8674c1d", "version": 1, "description": null }, "framework": null }, "subkind": "primary", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:23.474+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "b355e65d-713a-409e-8cff-886a360b7b95", "parentComponentId": null }, { "bbox": { "h": 0.03, "w": 0.86, "x": 0.07, "y": 0.86 }, "kind": "callout", "text": "NOP is primarily for smaller programs “wanting to get into the game”", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": null, "subkind": { "name": "Primary callout", "slug": "primary", "status": "active", "canonId": "019de52c-fbd1-70eb-a9ce-8997f8674c1d", "version": 1, "description": null }, "framework": null }, "subkind": "primary", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:23.474+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "e8e7e6df-29e2-4c0b-9990-69a9d9246c4f", "parentComponentId": null }, { "bbox": null, "kind": "callout", "text": "They absolutely would take it because it represents - even if it's a wash financially, it gets your numbers up, particularly if you're not already a high-volume center.", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:08+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a97b-5f33b4e6e6cb", "parentComponentId": null }, { "bbox": { "h": 0.15, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "paragraph", "text": "TransMedics, we believe, exploits the fact that smaller, third-tier centers are desperate for organs to get their volumes up, and are therefore willing, we think, to pay exorbitant fees and to accept organs on its pump and its aircraft.", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:23.474+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "d7aac06c-4ea4-4ecc-b97c-f7a24a038d67", "parentComponentId": null }, { "bbox": { "h": 0.15, "w": 0.86, "x": 0.07, "y": 0.22 }, "kind": "quote", "text": "The Mass General physician detailed the do-or-die incentive that lead smaller centers to look the other way when TransMedics calls, stating the NOP is mainly for “small programs wanting to get into the game...I think exactly what they’re exploiting to increase the use of TransMedics.”", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:23.474+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "30234dc2-68c4-49ad-b466-e5b2e76a7d87", "parentComponentId": null }, { "bbox": { "h": 0.18, "w": 0.86, "x": 0.07, "y": 0.37 }, "kind": "quote", "text": "He stated that centers “absolutely would take” an organ on the condition that it’s on their pump – “even if it’s a wash financially, it gets your numbers up...you will, in the eyes of your institution and of payors, take on enhanced status...for being viewed as a higher volume center...you can put yourself in a position to compete for contracts...one way of getting the good stuff, so to speak...larger numbers aided and abetted by perfusion...a really interesting calculus being practiced by...centers that want to get bigger.”", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:23.474+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "3eeedf03-940b-430a-ba8b-7c0eeb42899b", "parentComponentId": null }, { "bbox": { "h": 0.07, "w": 0.86, "x": 0.07, "y": 0.89 }, "kind": "quote", "text": "“I understand the NOP service from the vantage point of early small programs wanting to get into the game, particularly when it comes to high-risk donors like DCDs. And that's, I think exactly what they're exploiting to increase the use of TransMedics.” – Transplant hepatologist at a leadership role at Harvard/Massachusetts General Hospital; key role in oversight of the liver transplant program", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:23.474+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "8bc9e037-fcab-4b87-be2b-8230a283ccf9", "parentComponentId": null }, { "bbox": { "h": 0.25, "w": 0.86, "x": 0.07, "y": 0.6 }, "kind": "quote", "text": "Q: “How much of an incentive is there for a center, if they get a call from TransMedics and they say this other center didn't want it. You've got to take it, but it's already on a TransMedics device, or we're going to put it on. That's the deal.” A: “Yeah, they would take it. They absolutely would take it because it represents - even if it's a wash financially, it gets your numbers up, particularly if you're not already a high-volume center. You get your numbers up. You will, in the eyes of your institution and of payors, take on enhanced status, at least for being viewed as a higher volume center and potentially can enhance your margins accordingly. In a way, this is kind of like a loss leader where you've got to do a bunch of these perfusion-supported cases so that you can put yourself in a position to compete for contracts so that you can get even more of the conventional risk cases that don't require perfusion. In a way, it's kind of like one way of getting the good stuff, so to speak, to take on larger numbers aided and abetted and improved by perfusion It's a really interesting calculus that's being practiced by these kinds of centers that want to get bigger.” – Transplant hepatologist at a leadership role at Harvard/Massachusetts General Hospital; key role in oversight of the liver transplant program", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:23.474+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "ff8142ab-0862-4d35-a898-130eb88548c5", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "“They absolutely would take it because it represents - even if it's a wash financially, it gets your numbers up, particularly if you're not already a high-volume center. You get your numbers up. You will, in the eyes of your institution and of payors, take on enhanced status, at least for being viewed as a higher volume center and potentially can enhance your margins accordingly. In a way, this is kind of like a loss leader where you've got to do a bunch of these perfusion-supported cases so that you can put yourself in a position to compete for contracts so that you can get even more of the conventional risk cases that don't require perfusion. In a way, it's kind of like one way of getting the good stuff, so to speak, to take on larger numbers aided and abetted and improved by perfusion It's a really interesting calculus that's being practiced by these kinds of centers that want to get bigger.” — Transplant hepatologist in a leadership role at Harvard/Massachusetts General Hospital; key role in oversight of the liver transplant program", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:08+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a97b-62b3053bf42b", "parentComponentId": null }, { "bbox": { "h": 0.02, "w": 0.3, "x": 0.07, "y": 0.97 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:23.474+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "800c4ea7-d1cf-4acd-8387-1b6b598774e5", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [], "arcBeats": [], "loops": [], "locked": true }, { "page": 131, "type": "tension", "title": "The slide uses a Q&A transcript format to highlight a competitor's critique of the subject company's business model.", "function": "expose_contradiction", "rawType": "expose_contradiction", "block": null, "metadata": { "slideType": "expose_contradiction", "slideTypeCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-124c-75aa-984a-0a3d0d8fc8df", "version": 1, "description": null }, "function": "expose_contradiction", "functionCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-171f-776f-887c-73edaff4cf9c", "version": 1, "description": null }, "density": "balanced", "densityScore": 48, "componentCount": 5, "textChars": 2723, "nDataPoints": 0, "notes": "The slide uses a Q&A transcript format to highlight a competitor's critique of the subject company's business model.", "elementsJson": [ "paragraph", "quote_block", "footnote" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:12:21.444+00", "seconds": 3.732, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/131", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-131", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "it’s only useful for a small centers looking to jump the UNOS organ allocation algorithm and access organs via the NOP service", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:08+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a97b-450892387759", "parentComponentId": null }, { "bbox": { "h": 0.55, "w": 0.86, "x": 0.07, "y": 0.38 }, "kind": "paragraph", "text": "No value for large centers ;just small centers looking to jump UNOS allocation and get organs via NOP\nA: “Like I mentioned, not every case needs to be a TransMedics case.”\nQ: “So, you think there’s overutilization?”\nA: “Yeah, I think there’s overutilization when there clearly is not a clear clinical indication that it’s going to be beneficial for the patient…Let’s say I’m a very small center with limited resources, and I need an organ…it’s probably advantageous to do a TransMedics case in that regard because I’ll be able to get the organ faster…I’ll be able to probably get a match faster than I would with my current OPO infrastructure because I’m a small center, I’m going to have a small utilization from the OPO who’s going to want to give organs to a larger center. So, it helps me in that regard. Conversely, let’s say I’m a very large center, and I’m doing hundreds and hundreds of transplants a year. Do I really need this extra TransMedics case in order to do what exactly what I’m doing on my own? That’s what I’m talking about: for large centers, perhaps there is less clinical utility than for a small center.”\nQ: “What I’m hearing is that there’s tremendous overutilization, that it’s used for perfectly fine organs that would be fine on ice with no issue.”\nA: “Yeah, I agree. If it’s a donor service area that’s very small, like if you’re near a very large metropolitan area like New York or something, it’s out of the question. Why would you ever do that? You just have to drive across the river or something. It makes no sense.” – Senior medical employee at OrganOx", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:21.444+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "fbdf754b-bab8-4da8-a039-7e832c927a3d", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "“Yeah, I think there’s overutilization when there clearly is not a clear clinical indication that it’s going to be beneficial for the patient...it’s probably advantageous to do a TransMedics case in that regard because I’ll be able to get the organ faster...for large centers, perhaps there is less clinical utility than for a small center.” — Senior medical employee at OrganOx", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:08+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a97b-4bd05d273bc1", "parentComponentId": null }, { "bbox": { "h": 0.02, "w": 0.25, "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:21.444+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "3cf3ef13-da2f-4635-a023-6943a183466f", "parentComponentId": null }, { "bbox": { "h": 0.25, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "title", "text": "A senior medical employee of OrganOx, a competitor with a near-identical normothermic pump, provided the same color – that TransMedics makes no sense for large transplant centers, particularly in large metropolitan areas like New York, and it’s only useful for a small centers looking to jump the UNOS organ allocation algorithm and access organs via the NOP service: “let’s say I’m a very small center with limited resources and I need an organ…it’s probably advantageous to do a TransMedics case…I’ll be able to probably get a match faster than I would with my current OPO.”", "attrs": null, "canon": { "kind": { "name": "Title", "slug": "title", "status": "active", "canonId": "019de52c-f7dd-76d9-b848-b1f12bd85cf4", "version": 1, "description": "Slide title or headline." }, "tool": null, "subkind": { "name": "Headline", "slug": "headline", "status": "active", "canonId": "019de52c-fae1-7463-9a7c-d60668eced0d", "version": 1, "description": null }, "framework": null }, "subkind": "headline", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:21.444+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "b76a9daa-ce2b-4500-9fc7-7a1fb23c6d78", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [ { "matchId": "21891a65-e559-4297-a82b-17618005689a", "evidence": "The slide presents a competitor's testimony to undermine the value proposition of the subject company.", "framework": null, "confidence": 0.9, "extraction": { "at": "2026-05-02 20:12:21.444+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 131, "frameworkName": "expose_contradiction" } ], "arcBeats": [], "loops": [], "locked": true }, { "page": 132, "type": "evidence", "title": "The slide uses a 'villain' narrative framing, comparing the medical system to a cartel and highlighting the 'addiction to volume' as a driver for TransMedics se", "function": "illustrate_case", "rawType": "testimonial", "block": null, "metadata": { "slideType": "testimonial", "slideTypeCanon": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52d-0a2d-7782-8a48-7e84df92cc97", "version": 1, "description": null }, "function": "illustrate_case", "functionCanon": { "name": "Illustrate case", "slug": "illustrate_case", "status": "active", "canonId": "019de52d-13b4-772c-bb73-1873612a7463", "version": 1, "description": null }, "density": "balanced", "densityScore": 42, "componentCount": 6, "textChars": 1264, "nDataPoints": 0, "notes": "The slide uses a 'villain' narrative framing, comparing the medical system to a cartel and highlighting the 'addiction to volume' as a driver for TransMedics service adoption.", "elementsJson": [ "paragraph", "quote_block" ], "confidence": 0.95, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:12:20.887+00", "seconds": 3.163, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/132", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-132", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "the transplant administrators...they’re addicted to the volume", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:09+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a97b-86cf5091dd8a", "parentComponentId": null }, { "bbox": { "h": 0.15, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "paragraph", "text": "The Mass General physician’s quip - “one way of getting the good stuff, so to speak” - reminds one of a cartel servicing desperate addicts, and desperate is exactly the tone we sensed from TransMedics highest volume users, albeit for organs not drugs.", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:20.887+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "e32e65fa-0cb2-4ece-a18b-a99a99f0a0f2", "parentComponentId": null }, { "bbox": { "h": 0.15, "w": 0.86, "x": 0.07, "y": 0.78 }, "kind": "quote", "text": "It drops, and the transplant administrators are very concerned about that, but they’re addicted to the volume. You can dramatically increase your volume and your volume is also important because of your denominator.", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:20.887+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "252301fc-0071-433d-90ff-b3e9816fd22b", "parentComponentId": null }, { "bbox": { "h": 0.15, "w": 0.86, "x": 0.07, "y": 0.55 }, "kind": "quote", "text": "My OPO, the only thing they’re truly interested in is two metrics...so, if we can increase our lung volumes by, say, 40 lungs ... we’re a tier-one OPO, and that’s how close the margins are as far as being in compliance.", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:20.887+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "c61a96ef-d40a-4955-8031-c78ea10e234c", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "“one way of getting the good stuff, so to speak” — Mass General physician; “the transplant administrators...they’re addicted to the volume”; “if we can increase our lung volumes by, say 40 lungs...we’re a tier one OPO and that’s how close the margins are as far as being in compliance.”; “if I do 10 transplants, one or two deaths can shut down the program...but if I do 100, then I have a lot more leeway...the money is funny money.” — Transplant surgeon, Utah", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:09+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a97b-89beb489919d", "parentComponentId": null }, { "bbox": { "h": 0.03, "w": 0.3, "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:20.887+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "42fa72c7-52c9-4fd9-8280-a013dbe5e8df", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [ { "matchId": "b83022aa-72cb-49fc-bea4-bc42929c28a9", "evidence": "Framing the medical system as a 'cartel' and users as 'addicted to volume'", "framework": null, "confidence": 0.8, "extraction": { "at": "2026-05-02 20:12:20.887+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 132, "frameworkName": "antagonist-introduction" } ], "arcBeats": [], "loops": [], "locked": true }, { "page": 133, "type": "tension", "title": "The slide presents a narrative of systemic corruption and regulatory bypass involving TransMedics and OPOs.", "function": "expose_contradiction", "rawType": "expose_contradiction", "block": null, "metadata": { "slideType": "expose_contradiction", "slideTypeCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-124c-75aa-984a-0a3d0d8fc8df", "version": 1, "description": null }, "function": "expose_contradiction", "functionCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-171f-776f-887c-73edaff4cf9c", "version": 1, "description": null }, "density": "balanced", "densityScore": 30, "componentCount": 6, "textChars": 717, "nDataPoints": 0, "notes": "The slide presents a narrative of systemic corruption and regulatory bypass involving TransMedics and OPOs.", "elementsJson": [ "paragraph", "quote_block" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:12:25.531+00", "seconds": 7.646, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/133", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-133", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "TransMedics would then hijack and take over the organ allocation process from the OPO, and bypass the match list to start offering the organ preferentially.", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:08+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a97b-33df91b2d26b", "parentComponentId": null }, { "bbox": { "h": 0.03, "w": 0.86, "x": 0.07, "y": 0.615 }, "kind": "paragraph", "text": "TransMedics allegedly bypassing OPO's and UNOS with expedited offers to force usage of the device", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:25.531+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "9bfce522-ea0c-4e1d-9263-b63de80d465a", "parentComponentId": null }, { "bbox": { "h": 0.25, "w": 0.86, "x": 0.07, "y": 0.635 }, "kind": "paragraph", "text": "Q&A transcript between Scorpion Capital and a transplant surgeon regarding the manipulation of the expedited offer process.", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:25.531+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "e41909fe-bea1-4d9c-a653-57fc530edbb3", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "“the OPO’s are being cut out of the process by TransMedics...dictating where the organ is going or how the list is run.” — Transplant surgeon, Utah", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:08+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a97b-342f1ac1d600", "parentComponentId": null }, { "bbox": { "h": 0.02, "w": 0.3, "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:25.531+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "286bc8bd-6eff-4109-b443-b684bb9b29cb", "parentComponentId": null }, { "bbox": { "h": 0.25, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "title", "text": "The Utah surgeon detailed the inner workings of how TransMedics and corrupt OPO’s could conspire to exploit the “expedited offer” loophole", "attrs": null, "canon": { "kind": { "name": "Title", "slug": "title", "status": "active", "canonId": "019de52c-f7dd-76d9-b848-b1f12bd85cf4", "version": 1, "description": "Slide title or headline." }, "tool": null, "subkind": { "name": "Headline", "slug": "headline", "status": "active", "canonId": "019de52c-fae1-7463-9a7c-d60668eced0d", "version": 1, "description": null }, "framework": null }, "subkind": "headline", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:25.531+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "f392830f-87f2-4178-8a1e-098a4d2a15a0", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [ { "matchId": "8e7fa5d3-781c-4c5a-b045-86a4a7cf3b0c", "evidence": "The slide explicitly details a mechanism for bypassing regulatory systems (UNOS) for financial gain.", "framework": null, "confidence": 0.9, "extraction": { "at": "2026-05-02 20:12:25.531+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 133, "frameworkName": "fraud-exposure" } ], "arcBeats": [], "loops": [], "locked": true }, { "page": 134, "type": "tension", "title": "The slide uses a Q&A format to document expert testimony regarding potential kickbacks and regulatory circumvention.", "function": "expose_contradiction", "rawType": "expose_contradiction", "block": null, "metadata": { "slideType": "expose_contradiction", "slideTypeCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-124c-75aa-984a-0a3d0d8fc8df", "version": 1, "description": null }, "function": "expose_contradiction", "functionCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-171f-776f-887c-73edaff4cf9c", "version": 1, "description": null }, "density": "balanced", "densityScore": 42, "componentCount": 6, "textChars": 1057, "nDataPoints": 1, "notes": "The slide uses a Q&A format to document expert testimony regarding potential kickbacks and regulatory circumvention.", "elementsJson": [ "paragraph", "quote_block", "footnote" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:12:27.166+00", "seconds": 9.147, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/134", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-134", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "The conduct the surgeon described strikes us as nefarious and the type that risks FBI raids and indictments.", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:09+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a97b-f9aa6a7b7a53", "parentComponentId": null }, { "bbox": { "h": 0.25, "w": 0.86, "x": 0.07, "y": 0.68 }, "kind": "list", "text": "OPO's allegedly not being charged if organ on pump is not accepted", "attrs": null, "canon": { "kind": { "name": "List", "slug": "list", "status": "active", "canonId": "019de52c-f94b-779b-a53b-fd4904a5f4d2", "version": 1, "description": "Bullet or numbered list." }, "tool": null, "subkind": { "name": "Bullet list", "slug": "bullet", "status": "active", "canonId": "019de52c-fc98-7169-a083-5cab805076ca", "version": 1, "description": null }, "framework": null }, "subkind": "bullet", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:27.166+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "54541fe5-e2dc-4f7f-a0fb-9b03287d3d63", "parentComponentId": null }, { "bbox": { "h": 0.15, "w": 0.86, "x": 0.07, "y": 0.45 }, "kind": "list", "text": "Utah OPO allegedly storing TransMedics pumps to jump the gun on expedited offers", "attrs": null, "canon": { "kind": { "name": "List", "slug": "list", "status": "active", "canonId": "019de52c-f94b-779b-a53b-fd4904a5f4d2", "version": 1, "description": "Bullet or numbered list." }, "tool": null, "subkind": { "name": "Bullet list", "slug": "bullet", "status": "active", "canonId": "019de52c-fc98-7169-a083-5cab805076ca", "version": 1, "description": null }, "framework": null }, "subkind": "bullet", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:27.166+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "de7aeaec-614b-4f87-a311-e8b0398040d5", "parentComponentId": null }, { "bbox": { "h": 0.35, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "paragraph", "text": "The conduct the surgeon described strikes us as nefarious and the type that risks FBI raids and indictments...", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:27.166+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "60706661-07cd-4a31-9ab2-7dae5ee86e98", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "“Yeah, that’s exactly right. I’ve seen that where it’s like we have a liver on pump - other OPO’s where they’ve called us and said we’re just moving quick, if we bypass the list, would you accept this liver?” — Transplant surgeon, Utah; “The agreement is if we have a rapid donor that may not have serologies, we may not have list run; we may not have certain things, TransMedics is willing to because they’re using it as storage, send out a team, put it on pump with no home and then offer it out, and they’ll accept the cost if they don’t because ultimately, most of the time, those organs will be accepted.” — Transplant surgeon, Utah", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:09+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a97b-fe0189b0cbdc", "parentComponentId": null }, { "bbox": { "h": 0.03, "w": 0.3, "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:27.166+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "b6e07a7b-fd3b-4614-aa5a-3158cada100b", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [ { "matchId": "aaa48f80-fd90-4a1b-bbed-fbc635915aee", "evidence": "The slide explicitly frames the described business practices as 'nefarious' and 'risking FBI raids'.", "framework": null, "confidence": 0.9, "extraction": { "at": "2026-05-02 20:12:27.166+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 134, "frameworkName": "fraud-exposure" } ], "arcBeats": [], "loops": [], "locked": true }, { "page": 135, "type": "tension", "title": "The slide uses a Q&A format to highlight alleged unethical business practices.", "function": "expose_contradiction", "rawType": "expose_contradiction", "block": null, "metadata": { "slideType": "expose_contradiction", "slideTypeCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-124c-75aa-984a-0a3d0d8fc8df", "version": 1, "description": null }, "function": "expose_contradiction", "functionCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-171f-776f-887c-73edaff4cf9c", "version": 1, "description": null }, "density": "balanced", "densityScore": 45, "componentCount": 5, "textChars": 2021, "nDataPoints": 0, "notes": "The slide uses a Q&A format to highlight alleged unethical business practices.", "elementsJson": [ "paragraph", "quote_block", "footnote" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:12:25.399+00", "seconds": 7.356, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/135", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-135", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "He alleged that TransMedics gives the devices to the OPO at no cost – the very definition of a kickback", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:09+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a97c-12bb3e5d7542", "parentComponentId": null }, { "bbox": { "h": 0.45, "w": 0.86, "x": 0.07, "y": 0.41 }, "kind": "list", "text": "CEO’s of TransMedics and Utah OPO allegedly have a pre-existing personal relationship; OPO allegedly offered devices for free\nQ: “TransMedics approached you as the medical director of the OPO or the CEO of the OPO?”\nA: “They approached my CEO. My CEO and their CEO have known each other for a long time. And this was something that they’re going to try out.”\nQ: “What did TransMedics propose? What did they come and say?”\nA: “They said if you let us keep our stuff there, then if there are organs that are homeless or that are rapid, you can put them on and resuscitate them. TransMedics will put them on but there won’t be any repercussions if they don’t get placed. Like the OPO won’t have to pay for it...and then, if the lungs or the liver are functioning a certain way on the pump, it’s predictive of how they’re going to work, and then you can place those organs...what the OPO gets out of it is even more organs placed.” – Transplant surgeon, Utah", "attrs": null, "canon": { "kind": { "name": "List", "slug": "list", "status": "active", "canonId": "019de52c-f94b-779b-a53b-fd4904a5f4d2", "version": 1, "description": "Bullet or numbered list." }, "tool": null, "subkind": { "name": "Bullet list", "slug": "bullet", "status": "active", "canonId": "019de52c-fc98-7169-a083-5cab805076ca", "version": 1, "description": null }, "framework": null }, "subkind": "bullet", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:25.399+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "42e81ba4-7665-4125-8293-2634a5210e6c", "parentComponentId": null }, { "bbox": { "h": 0.35, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "paragraph", "text": "The surgeon stated that TransMedics “approached my CEO” – who we believe to be the CEO of DonorConnect, an OPO based in the Salt Lake City area with responsibility for Utah and parts of Idaho, Wyoming, and Nevada: “my CEO and their CEO have known each other a long time. And this was something that they’re going to try out.” He alleged that TransMedics gives the devices to the OPO at no cost – the very definition of a kickback: “they said if you let us keep our stuff there...if there are organs that are homeless or that are rapid, you can put them on...there won’t be any repercussions if they don’t get places...like the OPO won’t have to pay for it....”", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:25.399+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "d1e0e8df-6f8d-4394-a5fd-c2d6b9265eee", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "“They approached my CEO. My CEO and their CEO have known each other a long time. And this was something that they’re going to try out.” — Transplant surgeon, Utah", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:09+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a97c-152ef1304d5a", "parentComponentId": null }, { "bbox": { "h": 0.03, "w": 0.65, "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts; https://www.donorconnect.life/about-us/; https://www.youtube.com/watch?v=mmadFroPCpc", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:25.399+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "ee2acc2c-ed68-4b9d-84d2-bea5a9437b1b", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [ { "matchId": "d03a0d77-37f9-48f0-b2c5-4d7e6de78c0e", "evidence": "The slide explicitly frames the described business arrangement as 'the very definition of a kickback'.", "framework": null, "confidence": 0.9, "extraction": { "at": "2026-05-02 20:12:25.399+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 135, "frameworkName": "fraud-exposure" } ], "arcBeats": [], "loops": [], "locked": true }, { "page": 136, "type": "tension", "title": "The slide uses highlighted quotes from transplant surgeons to build a case for potential regulatory or ethical issues regarding TransMedics' business practices.", "function": "expose_contradiction", "rawType": "expose_contradiction", "block": null, "metadata": { "slideType": "expose_contradiction", "slideTypeCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-124c-75aa-984a-0a3d0d8fc8df", "version": 1, "description": null }, "function": "expose_contradiction", "functionCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-171f-776f-887c-73edaff4cf9c", "version": 1, "description": null }, "density": "balanced", "densityScore": 41, "componentCount": 4, "textChars": 1959, "nDataPoints": 0, "notes": "The slide uses highlighted quotes from transplant surgeons to build a case for potential regulatory or ethical issues regarding TransMedics' business practices.", "elementsJson": [ "paragraph", "quote_block", "footnote" ], "confidence": 0.95, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:12:21.599+00", "seconds": 3.356, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/136", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-136", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": { "h": 0.18, "w": 0.86, "x": 0.07, "y": 0.45 }, "kind": "callout", "text": "OPOs allegedly not paying for the devices; “just sort of a business relationship”\n“I know that they’ve been talking to our OPO about storing that stuff at a hub in Salt Lake City, but I don’t think that they’re making them pay for that because that’s different because the OPO’s don’t pay TransMedics. It’s just sort of a business relationship those two are working out…our area is getting more access to TransMedics, and the reason our OPO is open to that is because it’s really increasing the use of DCD organs for liver, but also it’s increasing the use of lungs. And I think that’s where our OPO is most interested…and so, if a lung center is saying we’ll use this if it’s resuscitated on a TransMedics device…” – Transplant surgeon, Utah", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": null, "subkind": { "name": "Primary callout", "slug": "primary", "status": "active", "canonId": "019de52c-fbd1-70eb-a9ce-8997f8674c1d", "version": 1, "description": null }, "framework": null }, "subkind": "primary", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:21.599+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "756ad5cf-88ed-462c-bd6f-d76590871181", "parentComponentId": null }, { "bbox": { "h": 0.12, "w": 0.86, "x": 0.07, "y": 0.65 }, "kind": "callout", "text": "Kickbacks, in our opinion, in the form of discounts for utilization and for keeping devices at OPO for expedited offers\n“We decided to use them for everything just because I think we got a deal with them on the first dozen livers or something like that…I had heard that the company is storing devices at certain places and maybe you can get a discount with that.” – Transplant surgeon, Utah", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": null, "subkind": { "name": "Primary callout", "slug": "primary", "status": "active", "canonId": "019de52c-fbd1-70eb-a9ce-8997f8674c1d", "version": 1, "description": null }, "framework": null }, "subkind": "primary", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:21.599+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "f02f966c-03ff-48a0-82e1-6b63bbfd3f9b", "parentComponentId": null }, { "bbox": { "h": 0.35, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "paragraph", "text": "The surgeon stated that TransMedics has similar arrangements with other OPO’s where devices are stored for free, which we heard directly from other OPO’s: “I heard that the company is storing devices at certain places”; “I don’t think that they’re making them pay for that…it’s just sort of a business relationship those two are working out” – referring to the CEO’s of his OPO and TransMedics. He stated the practice extends to both livers and lungs, and once again highlighted how centers are then basically forced to accept these organs on the device – with the OPO helping to pressure the center on TransMedics behalf: “I think that’s where out OPO is most interested…and so, if a lung center is saying we’ll use this it it’s resuscitated on a TransMedics device....”", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:21.599+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "c202fdb4-a8b7-4afa-bb4a-3780b116be13", "parentComponentId": null }, { "bbox": { "h": 0.02, "w": 0.25, "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:21.599+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "376e96b6-6f77-434c-aade-bed6934a0bbc", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [ { "matchId": "d722c5d6-9cd7-43ca-aa88-67dbe4e6c937", "evidence": "The slide explicitly frames the business relationship as 'Kickbacks' and 'allegedly not paying for the devices'.", "framework": null, "confidence": 0.9, "extraction": { "at": "2026-05-02 20:12:21.599+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 136, "frameworkName": "fraud-exposure" } ], "arcBeats": [], "loops": [], "locked": true }, { "page": 137, "type": "tension", "title": "The slide uses a Q&A format to highlight a specific allegation of unethical business practices.", "function": "expose_contradiction", "rawType": "villain_critique", "block": null, "metadata": { "slideType": "villain_critique", "slideTypeCanon": { "name": "Villain critique", "slug": "villain_critique", "status": "active", "canonId": "019de52d-10bc-7136-bf20-09de59d17447", "version": 1, "description": null }, "function": "expose_contradiction", "functionCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-171f-776f-887c-73edaff4cf9c", "version": 1, "description": null }, "density": "balanced", "densityScore": 34, "componentCount": 5, "textChars": 1100, "nDataPoints": 0, "notes": "The slide uses a Q&A format to highlight a specific allegation of unethical business practices.", "elementsJson": [ "paragraph", "quote_block", "footnote" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:12:22.933+00", "seconds": 4.512, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/137", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-137", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "I wouldn't be surprised. That would not surprise me at all...I think we have run into - we have been very clear with them. We don't agree with their business practices. We want nothing to do with them.", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:09+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a97b-e09deb37ed17", "parentComponentId": null }, { "bbox": { "h": 0.35, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "paragraph", "text": "An executive at a major West Coast OPO – one of the largest in the country – stated that TransMedics similarly tried to induce them to store devices and that it was likely a prevalent practice...", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:22.933+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "2f91ee33-2e4f-4ab4-97c6-f03067166b56", "parentComponentId": null }, { "bbox": { "h": 0.45, "w": 0.86, "x": 0.07, "y": 0.42 }, "kind": "quote", "text": "Q: It looks like there's been some DOJ settlements... A: I wouldn't be surprised. That would not surprise me at all... We don't agree with their business practices. We want nothing to do with them.", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:22.933+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "f35611b8-032a-4ff5-bc71-0310a86cd662", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "I wouldn't be surprised...that would not surprise me at all...we have been very clear with them...we don't agree with their business practices...we want nothing to do with them. TransMedics tried to get us to store their devices for them here also...they alleged that without that their service wouldn't work...we've always been very upfront...we're not going to engage in anything like that. — Executive at a West Coast OPO, longtime industry veteran", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:09+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a97b-e5f378a9451f", "parentComponentId": null }, { "bbox": { "h": 0.03, "w": 0.3, "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:22.933+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "6e982311-94cc-4399-82ef-0b8cc0d112c7", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [ { "matchId": "9aff58b2-f2cc-4db4-8304-9b304fb157d3", "evidence": "The slide frames TransMedics as a villainous actor through expert testimony.", "framework": null, "confidence": 0.9, "extraction": { "at": "2026-05-02 20:12:22.933+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 137, "frameworkName": "antagonist-introduction" } ], "arcBeats": [], "loops": [], "locked": true }, { "page": 138, "type": "tension", "title": "The slide presents a Q&A format with a surgeon, highlighting allegations of unethical business practices and operational friction.", "function": "name_villain", "rawType": "villain_critique", "block": null, "metadata": { "slideType": "villain_critique", "slideTypeCanon": { "name": "Villain critique", "slug": "villain_critique", "status": "active", "canonId": "019de52d-10bc-7136-bf20-09de59d17447", "version": 1, "description": null }, "function": "name_villain", "functionCanon": { "name": "Name villain", "slug": "name_villain", "status": "active", "canonId": "019de52d-1746-70d6-bc58-5eeaf5865526", "version": 1, "description": null }, "density": "dense", "densityScore": 62, "componentCount": 7, "textChars": 2613, "nDataPoints": 0, "notes": "The slide presents a Q&A format with a surgeon, highlighting allegations of unethical business practices and operational friction.", "elementsJson": [ "paragraph", "quote_block", "footnote" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:12:22.518+00", "seconds": 4.005, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/138", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-138", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "TransMedics is just pushing, and they’re rubbing people the wrong way.", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:09+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a97b-99d6e7ed3aec", "parentComponentId": null }, { "bbox": { "h": 0.05, "w": 0.86, "x": 0.07, "y": 0.51 }, "kind": "paragraph", "text": "TransMedics alleged trying to take over the organ allocation process from OPO's; some OPO's pushing back", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:22.518+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "04d9d62c-db16-49a7-9dfa-0bbee5927774", "parentComponentId": null }, { "bbox": { "h": 0.12, "w": 0.86, "x": 0.07, "y": 0.56 }, "kind": "paragraph", "text": "Q: “Are there any games that they played with your local OPO, where they’re trying to press their thumb on the OPO to run up TransMedics device volumes? I heard they’re doing that with OPO’s, like storing machines at the OPO. For example, the OPO says the patient’s already on TransMedics and they’re trying to leverage relationships with OPOs to get more utilization. Have you seen anything like that?”", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:22.518+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "183599e1-51fa-49bf-9605-9f4b84d601d1", "parentComponentId": null }, { "bbox": { "h": 0.25, "w": 0.86, "x": 0.07, "y": 0.68 }, "kind": "paragraph", "text": "A: “Definitely...I heard a lot of complaints about how TransMedics is trying to take over the case; TransMedics is trying to take over the organ allocation; TransMedics is just pushing, and they’re rubbing people the wrong way. What you saw is some fallout from that - this putting a liver onto the TransMedics device requires five units of blood. For the heart, it comes from the donor. For the liver, it comes from the blood bank. And the practice is then for TransMedics to ask the OPO or to request the hospital where the donor is located to procure five units of blood so that they can arrive there, and you get the blood from the blood bank to put the organ on the machine. And the OPOs, the one in Los Angeles, in particular, was starting to refuse to do that. They were starting to say we will not supply blood for TransMedics. And that became a real big sticking point that would get transplant programs in the middle of it. You’ve got to call the OPO and tell them to get the blood, or you’ve got to ship the blood—it was just a big mess. So, OPOs were looking at a way to retaliate or somewhat to put some pressure onto TransMedics. You can see that relationship is already under a lot of strain.” - Transplant surgeon", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:22.518+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "1d4ecd89-f3cc-48ea-94d9-fc0739bb1928", "parentComponentId": null }, { "bbox": { "h": 0.35, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "paragraph", "text": "One of TransMedics’ highest-volume users, a surgeon at an academic center, provided extensive color on what we interpret as an organ steering scheme and suggested that the company has hijacked the UNOS organ allocation process and national transplant waiting list.", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:22.518+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "7968a325-cce2-4bb4-b55c-20fcc0b8e07d", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "“Definitely...I heard a lot of complaints about how TransMedics is trying to take over the case; TransMedics is trying to take over the organ allocation; TransMedics is just pushing, and they’re rubbing people the wrong way...the OPOs, the one in Los Angeles, in particular, was starting to refuse to do that...OPOs were looking at a way to retaliate or somewhat to put some pressure onto TransMedics. You can see that relationship is already under a lot of strain.” — Transplant surgeon", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:09+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a97b-9c290d908ba9", "parentComponentId": null }, { "bbox": { "h": 0.02, "w": 0.3, "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:22.518+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "54a12453-d39d-4a82-aaef-d42c4a191cd4", "parentComponentId": null } ], "metrics": [], "tools": [ { "tool": { "name": "Anadiplosis", "slug": "anadiplosis", "status": "active", "bestFor": null, "canonId": "019dd956-a0a5-75f9-a98c-7b7d8ee377a1", "version": 1, "bodyDocId": null, "description": "Ending one clause with a word that begins the next", "familyLabel": null, "categoryName": "Loop", "categorySlug": "loop" }, "agent": "Storyteller", "layer": "slide", "agents": [ "Storyteller" ], "matchId": "53148255-b8f4-4fd8-b6f3-d437baa25fab", "evidence": "The text repeats similar phrases, such as 'TransMedics is trying to take over the case; TransMedics is trying to take over the organ allocation; TransMedics is just pushing'.", "pageRefs": null, "priority": null, "whenToUse": null, "confidence": 0.7, "extraction": { "at": "2026-07-16 23:10:34.450166+00", "model": "or:meta-llama/llama-4-scout", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 138, "whyItWorks": null, "antipattern": null, "cardinality": null, "narrativePurpose": null }, { "tool": { "name": "Villain naming", "slug": "villain-naming", "status": "active", "bestFor": "When governance or specific decisions are the core thesis", "canonId": "019dd9e1-55a4-74db-9314-0ced4cd46cd2", "version": 1, "bodyDocId": "019dd9a1-88f1-72ad-8f4e-56ec29d7b369", "description": "You identify a **specific person** responsible for the target's underperformance\nor the behaviour you want changed — and name them. Not \"management\" or \"the\nboard\". A named executive or director with a specific failure attributable to\nthem.", "familyLabel": null, "categoryName": null, "categorySlug": null }, "agent": null, "layer": "slide", "agents": null, "matchId": "99cfba8c-6406-4867-93cb-189e9b14b6ec", "evidence": "The slide describes TransMedics as hijacking the UNOS organ allocation process and national transplant waiting list.", "pageRefs": null, "priority": null, "whenToUse": "When governance or specific decisions are the core thesis", "confidence": 0.9, "extraction": { "at": "2026-07-16 23:10:34.408485+00", "model": "or:meta-llama/llama-4-scout", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 138, "whyItWorks": "- **Accountability needs a face.** Voters (shareholders, regulators,\n journalists) act faster against people than institutions.\n- **Credibility rises with specificity.** \"The CFO has repeatedly missed\n guidance\" > \"Management has missed guidance\".\n- It **pre-empts evasion**. An individual can be removed; an abstraction\n cannot.\n- It **forces the target to respond personally** — and their defensive\n response usually generates more attention for your thesis.", "antipattern": null, "cardinality": null, "narrativePurpose": null } ], "frameworks": [], "arcBeats": [], "loops": [], "locked": true }, { "page": 139, "type": "tension", "title": "The slide uses a Q&A format to present testimonial evidence of alleged misconduct.", "function": "name_villain", "rawType": "villain_critique", "block": null, "metadata": { "slideType": "villain_critique", "slideTypeCanon": { "name": "Villain critique", "slug": "villain_critique", "status": "active", "canonId": "019de52d-10bc-7136-bf20-09de59d17447", "version": 1, "description": null }, "function": "name_villain", "functionCanon": { "name": "Name villain", "slug": "name_villain", "status": "active", "canonId": "019de52d-1746-70d6-bc58-5eeaf5865526", "version": 1, "description": null }, "density": "dense", "densityScore": 55, "componentCount": 6, "textChars": 3299, "nDataPoints": 0, "notes": "The slide uses a Q&A format to present testimonial evidence of alleged misconduct.", "elementsJson": [ "paragraph", "quote_block", "footnote" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:12:22.322+00", "seconds": 3.787, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/139", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-139", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "The surgeon provided particularly damning detail which shows, in our opinion, that TransMedics is steering organs as a quid pro quo for device volumes – which would comprise a kickback as well as organ trafficking", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:09+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a97b-c805abdcd0e5", "parentComponentId": null }, { "bbox": { "h": 0.45, "w": 0.86, "x": 0.07, "y": 0.47 }, "kind": "list", "text": "Q: “If the surgeon on the other end at the center says they don’t want the organ and it’s already on a TransMedics device, they’re actually shopping it around? Doesn’t that violate the law, which has this protocol for how organ allocations are done?”\nA: “It can’t go down that way, for sure. They can’t give the organ away, but they would call and say, hey, would you be interested in this? And then someone says, oh yeah, I’d be interested in that, and then they say to the OPO, oh, so-and-so, the guy over in [readacted] is interested in this liver. You should give him a call. So, they’re getting into the organ allocation business rather than just the organ recovery and preservation business. It’s definitely improper.”\nQ: “How often do they do that? Have you seen them do that?”\nA: “Oh sure. I get phone calls from them. They’ve called me.”\nQ: “What do they say? This other surgeon didn’t want the organ; do you want it?”\nA: “Yes. Exactly that.”\nQ: “How often are they calling you?”\nA: “Me and my other partner who had the interactions; we are well known for our aggressive use of organs - for a while, we would get calls probably a couple of times a week, I would say.”\nQ: “Are you still getting calls a couple of times a week?”\nA: “It’s definitely died off. And we’re not sure whether they realize that’s not perhaps the best way or whether we’re not in good graces with them anymore because of our contracting dispute.” - Transplant surgeon at a high volume academic center", "attrs": null, "canon": { "kind": { "name": "List", "slug": "list", "status": "active", "canonId": "019de52c-f94b-779b-a53b-fd4904a5f4d2", "version": 1, "description": "Bullet or numbered list." }, "tool": null, "subkind": { "name": "Bullet list", "slug": "bullet", "status": "active", "canonId": "019de52c-fc98-7169-a083-5cab805076ca", "version": 1, "description": null }, "framework": null }, "subkind": "bullet", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:22.322+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "eb10938d-83d7-47a6-9875-9e012e8d16f6", "parentComponentId": null }, { "bbox": { "h": 0.03, "w": 0.86, "x": 0.07, "y": 0.43 }, "kind": "paragraph", "text": "Allegedly used to call twice a week to offer organs but now no longer call due to contracting dispute", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:22.322+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "73b8f015-9ceb-417f-8179-6d3e897c4c34", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "they would call and say, hey, would you be interested in this? And then someone says, oh yeah, I’d be interested in that, and then they say to the OPO, oh, so-and-so, the guy over in [readacted] is interested in this liver. They’re getting into the organ allocation business rather than just the organ recovery and preservation business. It’s definitely improper. — Transplant surgeon at a high volume academic center", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:09+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a97b-cebb27a03fc3", "parentComponentId": null }, { "bbox": { "h": 0.02, "w": 0.3, "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:22.322+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "c764f7d1-447b-4ab7-86e9-17b8713e6631", "parentComponentId": null }, { "bbox": { "h": 0.35, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "title", "text": "The surgeon provided particularly damning detail which shows, in our opinion, that TransMedics is steering organs as a quid pro quo for device volumes – which would comprise a kickback as well as organ trafficking, per our reading of the National Organ Transplant Act, which prohibits the exchange of organs for “valuable consideration.” The transplant surgeon stated that, prior to a current contracting dispute concerning extortionate air transport charges, his center would “get calls probably a couple of times a week” where TransMedics offered them organs as “expedited offers” but that it’s “definitely died off,” perhaps because “we’re not in good graces with them anymore because of our contracting dispute”: “they would call and say, hey, would you be interested in this?...and then they say to the OPO, oh, so-and-so, the guy over in [redacted] is interested in this liver...so, they’re getting into the organ allocation business rather than just the organ recovery and preservation business...it’s definitely improper.”", "attrs": null, "canon": { "kind": { "name": "Title", "slug": "title", "status": "active", "canonId": "019de52c-f7dd-76d9-b848-b1f12bd85cf4", "version": 1, "description": "Slide title or headline." }, "tool": null, "subkind": { "name": "Headline", "slug": "headline", "status": "active", "canonId": "019de52c-fae1-7463-9a7c-d60668eced0d", "version": 1, "description": null }, "framework": null }, "subkind": "headline", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:22.322+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "b3266452-9371-448e-9e51-51f774408732", "parentComponentId": null } ], "metrics": [], "tools": [ { "tool": { "name": "Call-and-Response", "slug": "call-and-response", "status": "active", "bestFor": null, "canonId": "019dd956-a254-7484-a9b7-721eb21444a5", "version": 1, "bodyDocId": null, "description": "Engaging audience by creating pattern they complete mentally", "familyLabel": null, "categoryName": "Loop", "categorySlug": "loop" }, "agent": "Storyteller", "layer": "slide", "agents": [ "Storyteller" ], "matchId": "8a7a42c1-de4a-4d75-9dcc-3bf2f2d719bb", "evidence": "The slide includes a Q&A format, with questions and answers that provide evidence for the allegations.", "pageRefs": null, "priority": null, "whenToUse": null, "confidence": 0.7, "extraction": { "at": "2026-07-16 23:10:34.534975+00", "model": "or:meta-llama/llama-4-scout", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 139, "whyItWorks": null, "antipattern": null, "cardinality": null, "narrativePurpose": null } ], "frameworks": [ { "matchId": "905fc085-31ce-4cdb-be6c-076a683b15c1", "evidence": "The slide frames TransMedics as a bad actor violating federal law.", "framework": null, "confidence": 0.8, "extraction": { "at": "2026-05-02 20:12:22.322+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 139, "frameworkName": "antagonist-introduction" } ], "arcBeats": [], "loops": [], "locked": true }, { "page": 140, "type": "tension", "title": "The slide uses a Q&A format to provide direct evidence of unethical behavior in the organ transplant system.", "function": "expose_contradiction", "rawType": "expose_contradiction", "block": null, "metadata": { "slideType": "expose_contradiction", "slideTypeCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-124c-75aa-984a-0a3d0d8fc8df", "version": 1, "description": null }, "function": "expose_contradiction", "functionCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-171f-776f-887c-73edaff4cf9c", "version": 1, "description": null }, "density": "balanced", "densityScore": 47, "componentCount": 5, "textChars": 2342, "nDataPoints": 0, "notes": "The slide uses a Q&A format to provide direct evidence of unethical behavior in the organ transplant system.", "elementsJson": [ "paragraph", "quote_block", "footnote" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:12:22.63+00", "seconds": 3.775, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/140", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-140", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "Our interviews with Utah and other high-volume centers were striking, as they detailed participation in what sounds to us like an overt organ trafficking racket while at the same time acknowledging that “it’s definitely improper”", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:09+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a97b-b0b5e4ae82c2", "parentComponentId": null }, { "bbox": { "h": 0.45, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "paragraph", "text": "Our interviews with Utah and other high-volume centers were striking, as they detailed participation in what sounds to us like an overt organ trafficking racket while at the same time acknowledging that “it’s definitely improper” – an illustration of the conflicted, corrupt cesspool that the current organ transplant system has become and why various national/state agencies and authorities are preparing to crack down. The center we quoted two pages ago, for example, admitted to boosting its volumes with questionable organs shopped to it by TransMedics – “we are well known for our aggressive use of organs” - while at the same time slamming the practice: “there’s a lot of gray area when it comes to how late declines are handled...that has certainly happened to me where I’ve been inappropriately skipped...that’s against regulations...that’s unethical...you can’t skip me without telling me...these things happen...”", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:22.63+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "6e8b2aca-df3d-4b1a-869a-e868860767f9", "parentComponentId": null }, { "bbox": { "h": 0.35, "w": 0.86, "x": 0.07, "y": 0.52 }, "kind": "quote", "text": "“Gray area” with inappropriate skipping of centers “unethical” Q: “Is there risk that somebody who would have gotten an organ through the algorithm did not because they just hijacked it and they’re working some relationship and pressuring some OPO? It seems like if this is happening at 2 am –” A: “There’s a lot of gray area when it comes to how late declines are offered. That has certainly happened to me where I’ve been inappropriately skipped, and I had to call an OPO and say you can’t do that. That’s against regulations. That’s unethical; you can’t skip me without telling me. These things happen. What the recourse is for anybody is a tougher question.” - Transplant surgeon at a high volume academic center", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:22.63+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "db4d0b64-1197-4239-afd4-bae90caee40f", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "“There’s a lot of gray area when it comes to how late declines are offered. That has certainly happened to me where I’ve been inappropriately skipped, and I had to call an OPO and say you can’t do that. That’s against regulations. That’s unethical; you can’t skip me without telling me. These things happen. What the recourse is for anybody is a tougher question.” — Transplant surgeon at a high volume academic center", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:09+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a97b-b5a8a197956e", "parentComponentId": null }, { "bbox": { "h": 0.02, "w": 0.25, "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:22.63+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "20b1c2c0-0356-45a7-9305-82288711d877", "parentComponentId": null } ], "metrics": [], "tools": [ { "tool": { "name": "Emotional Appeal", "slug": "emotional-appeal", "status": "active", "bestFor": null, "canonId": "019dd956-bde9-7668-8be7-0097678fec59", "version": 1, "bodyDocId": null, "description": "Connecting to audience feelings rather than just logic", "familyLabel": null, "categoryName": "Slide", "categorySlug": "slide" }, "agent": "Storyteller", "layer": "slide", "agents": [ "Storyteller" ], "matchId": "c2e8d1fe-4e54-4e1e-a7f2-8573fe65dbe3", "evidence": "The quote 'It’s deceptive, it’s wrong, and frankly, we are concerned that it could have caused harm to patients' evokes emotions.", "pageRefs": null, "priority": null, "whenToUse": null, "confidence": 0.5, "extraction": { "at": "2026-07-16 23:10:34.615945+00", "model": "or:meta-llama/llama-4-scout", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 140, "whyItWorks": null, "antipattern": null, "cardinality": null, "narrativePurpose": null } ], "frameworks": [], "arcBeats": [], "loops": [], "locked": true }, { "page": 141, "type": "tension", "title": "The slide uses a Q&A format to highlight alleged procedural violations. The yellow highlighting emphasizes the specific claims of bypassing the OPO.", "function": "expose_contradiction", "rawType": "expose_contradiction", "block": null, "metadata": { "slideType": "expose_contradiction", "slideTypeCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-124c-75aa-984a-0a3d0d8fc8df", "version": 1, "description": null }, "function": "expose_contradiction", "functionCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-171f-776f-887c-73edaff4cf9c", "version": 1, "description": null }, "density": "dense", "densityScore": 55, "componentCount": 6, "textChars": 3227, "nDataPoints": 0, "notes": "The slide uses a Q&A format to highlight alleged procedural violations. The yellow highlighting emphasizes the specific claims of bypassing the OPO.", "elementsJson": [ "paragraph", "quote_block", "footnote" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:12:23.073+00", "seconds": 3.946, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/141", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-141", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "The ex-employee stated TransMedics bypasses the OPO: \"they're just kind of doing it and saying, oh, this is an aggressive center and they could use it.\"", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:10+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a97c-7489f8b8e842", "parentComponentId": null }, { "bbox": { "h": 0.25, "w": 0.86, "x": 0.07, "y": 0.63 }, "kind": "list", "text": "Q: \"What did you observe as far as the interaction between the OCS team, the TransMedics surgeon, and the transplant surgeon waiting on the other end?\"\nA: \"A couple of times, the first center would say we don't want this liver for whatever reason. And then, it's supposed to go to the OPO to reallocate this liver. But as soon as TransMedics finds out, they have quite the list of backups, and they are already calling other surgeons and being like, could you potentially use this liver? So, there are a lot of these conversations happening. I'm not exactly sure what is said or how it goes. I just know that these phone calls are being made and then it's like coming back into the OR and being like, this particular surgeon could use this liver. Why don't you call them?\"\nQ: \"Are they going through the system and the OPO, or are they just kind of doing it themselves?\"\nA: \"No, they're just kind of doing it and saying, oh, this is an aggressive center, and they could use it. I mean, the OPO does push back. I know that they do unless they go through the process like they're supposed to. But there are a lot of incoming phone calls and text messages from the powers that be in Boston trying to have their input.\" - Former TransMedics OCS specialist", "attrs": null, "canon": { "kind": { "name": "List", "slug": "list", "status": "active", "canonId": "019de52c-f94b-779b-a53b-fd4904a5f4d2", "version": 1, "description": "Bullet or numbered list." }, "tool": null, "subkind": { "name": "Bullet list", "slug": "bullet", "status": "active", "canonId": "019de52c-fc98-7169-a083-5cab805076ca", "version": 1, "description": null }, "framework": null }, "subkind": "bullet", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:23.073+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "e8d51ebf-22ae-48a7-9a64-90e265ea975b", "parentComponentId": null }, { "bbox": { "h": 0.04, "w": 0.86, "x": 0.07, "y": 0.59 }, "kind": "paragraph", "text": "TransMedics allegedly takes over the organ allocation process inside the OR and calls potential recipient centers itself", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:23.073+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "9a7ef25c-08ff-43b4-ba88-b78500ec7c65", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "\"it's supposed to go to the OPO to reallocate the liver...but as soon as TransMedics finds out, they have quite the list of backups, they are already calling other surgeons and being like, could you potentially use this liver?...a lot of these conversations [are] happening...I'm not exactly sure what is said...I just know that these phone calls are being made and then it's...coming back into the OR and being like, this particular surgeon could use this liver. Why don't you call them?\" — Former TransMedics OCS specialist", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:10+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a97c-7831c33cfc69", "parentComponentId": null }, { "bbox": { "h": 0.02, "w": 0.3, "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:23.073+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "a60be858-b4e0-4372-b87a-468dde259aed", "parentComponentId": null }, { "bbox": { "h": 0.45, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "title", "text": "TransMedics alleged interference in the organ allocation process, in what appears to be a violation of the UNOS transplant waiting list rules, was corroborated by former employees as well as current staff at transplant centers who are inside operating rooms while the NOP procurement team retrieves organs. A former TransMedics OCS specialist - who operates the device and manages an organ on the pump - described personally witnessing how the team allegedly hijacks the registry: \"it's supposed to go to the OPO to reallocate the liver...but as soon as TransMedics finds out, they have quite the list of backups, they are already calling other surgeons and being like, could you potentially use this liver?...a lot of these conversations [are] happening...I'm not exactly sure what is said...I just know that these phone calls are being made and then it's...coming back into the OR and being like, this particular surgeon could use this liver. Why don't you call them?\" The ex-employee stated TransMedics bypasses the OPO: \"they're just kind of doing it and saying, oh, this is an aggressive center and they could use it.\"", "attrs": null, "canon": { "kind": { "name": "Title", "slug": "title", "status": "active", "canonId": "019de52c-f7dd-76d9-b848-b1f12bd85cf4", "version": 1, "description": "Slide title or headline." }, "tool": null, "subkind": { "name": "Headline", "slug": "headline", "status": "active", "canonId": "019de52c-fae1-7463-9a7c-d60668eced0d", "version": 1, "description": null }, "framework": null }, "subkind": "headline", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:23.073+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "ad148c67-57e9-4f38-bf45-a44fdceb4d76", "parentComponentId": null } ], "metrics": [], "tools": [ { "tool": { "name": "Logical chain", "slug": "logical-chain", "status": "active", "bestFor": null, "canonId": "019dd9e1-5104-702f-8953-85757af6553d", "version": 1, "bodyDocId": null, "description": "If-then, premise-conclusion, deductive chain.", "familyLabel": null, "categoryName": null, "categorySlug": null }, "agent": null, "layer": "slide", "agents": null, "matchId": "50f31848-5f68-4067-acdd-57fbfa394989", "evidence": "The text outlines a logical sequence of events, showing how TransMedics allegedly bypasses the OPO.", "pageRefs": null, "priority": null, "whenToUse": null, "confidence": 0.7, "extraction": { "at": "2026-07-16 23:10:34.695654+00", "model": "or:meta-llama/llama-4-scout", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 141, "whyItWorks": null, "antipattern": null, "cardinality": "common", "narrativePurpose": null } ], "frameworks": [], "arcBeats": [], "loops": [], "locked": true }, { "page": 142, "type": "tension", "title": "Includes a Q&A transcript excerpt highlighting potential ethical/regulatory concerns regarding organ allocation and communication methods.", "function": "expose_contradiction", "rawType": "expose_contradiction", "block": null, "metadata": { "slideType": "expose_contradiction", "slideTypeCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-124c-75aa-984a-0a3d0d8fc8df", "version": 1, "description": null }, "function": "expose_contradiction", "functionCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-171f-776f-887c-73edaff4cf9c", "version": 1, "description": null }, "density": "dense", "densityScore": 54, "componentCount": 6, "textChars": 2701, "nDataPoints": 0, "notes": "Includes a Q&A transcript excerpt highlighting potential ethical/regulatory concerns regarding organ allocation and communication methods.", "elementsJson": [ "paragraph", "quote_block", "footnote" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:12:27.131+00", "seconds": 7.896, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/142", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-142", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "The ex-OCS specialist stated that TransMedics executive team is on text messages and internal chats to direct the scheme during organ procurements in the OR", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:09+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a97c-43050b01a1f2", "parentComponentId": null }, { "bbox": { "h": 0.38, "w": 0.86, "x": 0.07, "y": 0.55 }, "kind": "paragraph", "text": "Senior TransMedics management allegedly directing organs to “aggressive” centers\nQ: “Do you know how that worked? Were they offering organs to surgeons that were heavy TransMedics users?”\nA: “Pretty much, because the aggressive centers are all the ones - or the ones that they would call aggressive centers, we were at very frequently. So, they would say an aggressive center, and it would be like San Diego or Arizona Mayo.”\nQ: “So they basically have a list of people who would take an organ that other people didn’t want?”\nA: “Yeah.”\nQ: “You said text messages and calls were flying. Who was doing those? Was this the CEO or Magdy Attia?”\nA: “The only ones that I knew who for sure knew what was going on were Magdy and them. They’re always on the internal and external chats. All of the higher-ups can always see what’s going on at all times because they’re part of these threads.”\nQ: “And this chat is like a Slack channel or something like that?”\nA: “There’s an app and it’s also text messages.”\nQ: “Like regular text? Like not WhatsApp, like regular text?”\nA: “Like regular iPhone text messages.”\nQ: “Wow, is that like HIPAA compliant? Aren’t there rules around this stuff?”\nA: “I don’t know the correct answer to that.” - Former TransMedics OCS specialist", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:27.131+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "027d4f6f-09f5-47f1-be91-2b749f739589", "parentComponentId": null }, { "bbox": { "h": 0.25, "w": 0.86, "x": 0.07, "y": 0.22 }, "kind": "paragraph", "text": "The ex-employee singled out Magdy Attia in particular – a fellow Egyptian and confidante of the CEO, the “Chief of OCS Liver Transplant program at TransMedics” per LinkedIn – “ones that I knew who for sure knew what was going on were Magdy and them...they’re always on the internal and external chats...all of the higher-ups can always see what’s going on at all time because they’re part of these threads.” The OCS specialist stated that the calls from the OR were going to TransMedics highest volume customers – particularly UC San Diego and Mayo Arizona – who we believe to be fully aware of the quid pro quo that they get the organ in exchange for taking it on the pump: “the ones that they would call aggressive centers, we were at very frequently....it would be like San Diego or Arizona Mayo.”", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:27.131+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "dc405b61-1970-4f6e-b418-939c3badfab1", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "“Pretty much, because the aggressive centers are all the ones - or the ones that they would call aggressive centers, we were at very frequently. So, they would say an aggressive center, and it would be like San Diego or Arizona Mayo.” — Former TransMedics OCS specialist", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:09+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a97c-44dc08b39f7e", "parentComponentId": null }, { "bbox": { "h": 0.03, "w": 0.3, "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:27.131+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "55697dcc-f87e-4c01-b74e-5901f65046c7", "parentComponentId": null }, { "bbox": { "h": 0.15, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "title", "text": "The ex-OCS specialist stated that TransMedics executive team is on text messages and internal chats to direct the scheme during organ procurements in the OR", "attrs": null, "canon": { "kind": { "name": "Title", "slug": "title", "status": "active", "canonId": "019de52c-f7dd-76d9-b848-b1f12bd85cf4", "version": 1, "description": "Slide title or headline." }, "tool": null, "subkind": { "name": "Headline", "slug": "headline", "status": "active", "canonId": "019de52c-fae1-7463-9a7c-d60668eced0d", "version": 1, "description": null }, "framework": null }, "subkind": "headline", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:27.131+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "64212895-e011-47c6-a66f-1209d40c969c", "parentComponentId": null } ], "metrics": [], "tools": [ { "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null, "categoryName": null, "categorySlug": null }, "agent": null, "layer": "slide", "agents": null, "matchId": "d76c5b27-1656-4faa-9bf9-abe93dd571b2", "evidence": "The source note cites 'Scorpion Capital consultation calls with experts' as the authority for the allegations.", "pageRefs": null, "priority": null, "whenToUse": null, "confidence": 0.7, "extraction": { "at": "2026-07-16 23:10:34.776321+00", "model": "or:meta-llama/llama-4-scout", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 142, "whyItWorks": null, "antipattern": null, "cardinality": "common", "narrativePurpose": null } ], "frameworks": [], "arcBeats": [], "loops": [], "locked": true }, { "page": 143, "type": "tension", "title": "The slide uses a 'smoking gun' narrative to frame the testimonial as evidence of unethical business practices.", "function": "expose_contradiction", "rawType": "expose_contradiction", "block": null, "metadata": { "slideType": "expose_contradiction", "slideTypeCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-124c-75aa-984a-0a3d0d8fc8df", "version": 1, "description": null }, "function": "expose_contradiction", "functionCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-171f-776f-887c-73edaff4cf9c", "version": 1, "description": null }, "density": "balanced", "densityScore": 47, "componentCount": 5, "textChars": 2372, "nDataPoints": 0, "notes": "The slide uses a 'smoking gun' narrative to frame the testimonial as evidence of unethical business practices.", "elementsJson": [ "paragraph", "quote_block", "footnote" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:12:22.809+00", "seconds": 3.497, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/143", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-143", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "TransMedics not only seems to steer organs to “aggressive” centers, but that it explicitly appears to skip those unwilling to take it on the device, moving to the next “aggressive center” on their list until they land one – a clear indication, in our view, that organs are trafficked as a kickback for device usage.", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:10+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a97c-f7a6b6da741e", "parentComponentId": null }, { "bbox": { "h": 0.3, "w": 0.86, "x": 0.07, "y": 0.65 }, "kind": "quote", "text": "Smoking gun – allegedly steered organ away from a high-volume center because wouldn’t take it on the device. Q: 'You mentioned that they’re calling around if the receiving center didn’t want the organ - texting and whatever.' A: 'Yeah...there was an instance where I was in the OR and the original center that was supposed to take a liver said we don’t want it. So, they had gone to the next place...'", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:22.809+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "3f7b9fcd-5380-499a-9408-eeb15a8910c0", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "Yeah...there was an instance where I was in the OR and the original center that was supposed to take a liver said we don’t want it. So, they had gone to the next place. And the next place was like, yeah, we’d like the liver. And so, we have TransMedics in the OR. Do you want to use them? And I believe it was a hospital that I think was in Arizona, and they’re like, well, yeah, I think we would love to do that but we don’t know what to do and everything. So, they were thinking about it. I remember they were on the phone, and then they were like, actually, never mind. We just want it on ice. We don’t want - they talked to the people from corporate at TransMedics because they were trying to get them to be like, oh, we can do a contract, and you can take it on OCS, and I think they were like, never mind, we want it on ice, so it didn’t go to that aggressive center...I know a lot of the times TransMedics would call, after the original hospital that was supposed to take this liver refused it. So, they would say, here’s a list of aggressive centers. Make sure you remind them who the aggressive centers are...they were very much campaigning for them. But they were always organs that had already been turned down by the first place...and then the next place would get to decide. But they really did want it to go on OCS once they were already there. — Former OCS Specialist", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:10+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a97c-fb9cc2c7d63b", "parentComponentId": null }, { "bbox": { "h": 0.02, "w": 0.25, "x": 0.07, "y": 0.96 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:22.809+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "049f6063-e38a-4811-9cb2-dd81bdb5dabe", "parentComponentId": null }, { "bbox": { "h": 0.25, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "title", "text": "Another OCS Specialist providing what we believe is a smoking gun that TransMedics not only seems to steer organs to “aggressive” centers, but that it explicitly appears to skip those unwilling to take it on the device", "attrs": null, "canon": { "kind": { "name": "Title", "slug": "title", "status": "active", "canonId": "019de52c-f7dd-76d9-b848-b1f12bd85cf4", "version": 1, "description": "Slide title or headline." }, "tool": null, "subkind": { "name": "Headline", "slug": "headline", "status": "active", "canonId": "019de52c-fae1-7463-9a7c-d60668eced0d", "version": 1, "description": null }, "framework": null }, "subkind": "headline", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:22.809+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "f3678e52-18e1-47ac-a05d-02777c9e3162", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [ { "matchId": "aec7fbdb-4dcc-4ab1-a391-e8e6380f9986", "evidence": "The slide explicitly frames the testimonial as a 'smoking gun' to expose alleged unethical business practices.", "framework": null, "confidence": 0.9, "extraction": { "at": "2026-05-02 20:12:22.809+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 143, "frameworkName": "fraud-exposure" } ], "arcBeats": [], "loops": [], "locked": true }, { "page": 144, "type": "tension", "title": "Includes a Q&A transcript excerpt as evidence for the allegations.", "function": "expose_contradiction", "rawType": "expose_contradiction", "block": null, "metadata": { "slideType": "expose_contradiction", "slideTypeCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-124c-75aa-984a-0a3d0d8fc8df", "version": 1, "description": null }, "function": "expose_contradiction", "functionCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-171f-776f-887c-73edaff4cf9c", "version": 1, "description": null }, "density": "balanced", "densityScore": 49, "componentCount": 5, "textChars": 2871, "nDataPoints": 0, "notes": "Includes a Q&A transcript excerpt as evidence for the allegations.", "elementsJson": [ "paragraph", "quote_block", "footnote" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:12:26.216+00", "seconds": 6.829, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/144", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-144", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "TransMedics is allegedly pushing questionable organs that reputable centers won't touch - and these dubious organs appear to be the currency by which TransMedics boosts device volumes and by which its top users boost their transplant volumes.", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:09+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a97c-29b6c9667d2b", "parentComponentId": null }, { "bbox": { "h": 0.28, "w": 0.86, "x": 0.07, "y": 0.62 }, "kind": "paragraph", "text": "Surgical technician: TransMedics contacting centers to shop questionable organs\nQ: “I’m hearing that sometimes the receiving center doesn’t want the organ and TransMedics is bypassing the organ allocation system - they’re just texting and calling surgeons that use the device a lot, saying will you take it? And, obviously, they’re never going to call anybody who’s not a TransMedics user because the deal is we can get you this organ, but it’s going to be on a TransMedics device. That sounds like a hardcore kickback.”\nA: “Yeah, for sure. I was in a recent operating room where TransMedics was there. It was a DCD, and the patient ended up not passing, but because the time frame expired, they went to another center and TransMedics did contact that center. I’m not 100% sure how the OPO was involved in that, but TransMedics was definitely contacting other centers, saying if we go past 120 minutes...” – Organ procurement technician at a high volume Northwest academic transplant center", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:26.216+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "0a4eabe2-8b4b-4fe5-8897-72f70e1dfe97", "parentComponentId": null }, { "bbox": { "h": 0.45, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "paragraph", "text": "TransMedics alarming alleged conduct inside operating rooms appears to be well-known among surgical staff at major transplant centers. An organ procurement technician at a leading center in the Pacific Northwest – who travels frequently to retrieve organs and is often in the operating room with TransMedics procurement teams – confirmed the modus operandi: “I was in a recent operating room where TransMedics was” and that its team “was definitely contacting other centers, saying if we go past the 120 minutes....” The technician was referring to a DCD donor that didn’t expire in time, meaning the organ was compromised due to an extended lack of circulation. The first center on the match list therefore declined the organ – but TransMedics allegedly contacted centers willing to take an organ with a warm ischemic time of over 2 hours. In other words, as we detail in a separate chapter, TransMedics is allegedly pushing questionable organs that reputable centers won’t touch – and these dubious organs appear to be the currency by which TransMedics boosts device volumes and by which its top users boost their transplant volumes.", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:26.216+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "8965f9d5-77df-4cb7-96d7-938dbfa4dd0e", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "I was in a recent operating room where TransMedics was there. It was a DCD, and the patient ended up not passing, but because the time frame expired, they went to another center and TransMedics did contact that center. I'm not 100% sure how the OPO was involved in that, but TransMedics was definitely contacting other centers, saying if we go past 120 minutes... — Organ procurement technician at a high volume Northwest academic transplant center", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:09+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a97c-2f1962e25199", "parentComponentId": null }, { "bbox": { "h": 0.02, "w": 0.25, "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:26.216+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "0dc87c70-2ad6-41f3-88b5-820ac41c3538", "parentComponentId": null } ], "metrics": [], "tools": [ { "tool": { "name": "Narrative foundations (from the Storymakers methodology)", "slug": "narrative-foundations", "status": "active", "bestFor": null, "canonId": "019df269-258b-71bd-ad14-53598df04d2b", "version": 1, "bodyDocId": "019df269-2567-736e-8b9c-4ec77611334a", "description": "This skill focuses on the *adversarial* genre — activist campaigns, short", "familyLabel": "narrative-block", "categoryName": "Narrative & Transformation", "categorySlug": "narrative-transformation" }, "agent": "storyteller", "layer": "slide", "agents": [ "storyteller" ], "matchId": "ca49df01-3469-4cab-aed8-5bc1186e9c2a", "evidence": "The text provides a narrative of events, setting a foundation for the allegations.", "pageRefs": null, "priority": null, "whenToUse": null, "confidence": 0.5, "extraction": { "at": "2026-07-16 23:10:34.911779+00", "model": "or:meta-llama/llama-4-scout", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 144, "whyItWorks": null, "antipattern": null, "cardinality": null, "narrativePurpose": null } ], "frameworks": [], "arcBeats": [], "loops": [], "locked": true }, { "page": 145, "type": "tension", "title": "The slide uses a Q&A format to present testimony from an industry veteran, highlighting allegations of unethical sales practices.", "function": "expose_contradiction", "rawType": "quote_slide", "block": null, "metadata": { "slideType": "quote_slide", "slideTypeCanon": { "name": "Quote slide", "slug": "quote_slide", "status": "active", "canonId": "019de52d-098e-7555-a9fd-4f0af7e80bc2", "version": 1, "description": null }, "function": "expose_contradiction", "functionCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-171f-776f-887c-73edaff4cf9c", "version": 1, "description": null }, "density": "dense", "densityScore": 64, "componentCount": 7, "textChars": 3193, "nDataPoints": 0, "notes": "The slide uses a Q&A format to present testimony from an industry veteran, highlighting allegations of unethical sales practices.", "elementsJson": [ "paragraph", "quote_block", "footnote" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:12:22.68+00", "seconds": 3.17, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/145", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-145", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "they are very high pressure...they just want somebody to use it so that they get paid...so, they start making their calls...they're going down their own Rolodex of their paying customers. If my mom is listed at a transplant center down the road, she doesn't get a call. Patients are being skipped routinely and often. The calls are only going to the centers that are willing to pay for these machines.", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:10+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a97d-0c3b544fb6b8", "parentComponentId": null }, { "bbox": { "h": 0.35, "w": 0.86, "x": 0.07, "y": 0.48 }, "kind": "paragraph", "text": "Q: “It sounds like they’re very high pressure, like manipulating and pushing the organ allocation process.”\nA: “They are. In a real-life scenario, what ends up happening is when an organ is declined at the last minute like that, the OPO is really charged and held responsible with the utilization of the organ...but, they are very high pressure. I think they’ve got two things on their mind. One is that—I am confident that they’re not doing that work because they want to rescue this organ. What they want is they want to get paid...they just want somebody to use it so that they get paid...so, they start making their calls...they’re going down their own Rolodex of their paying customers. If my mom is listed at a transplant center down the road, she doesn’t get a call. Patients are being skipped routinely and often. The calls are only going to the centers that are willing to pay for these machines.”\nQ: “That’s 100% a kickback.”\nA: “Yeah.” – Executive at a West Coast OPO, longtime industry veteran", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:22.68+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "373dd715-e5ac-4f3f-b41d-21f80598a99a", "parentComponentId": null }, { "bbox": { "h": 0.03, "w": 0.86, "x": 0.07, "y": 0.45 }, "kind": "paragraph", "text": "TransMedics “going down their own Rolodex” and “patients are being skipped routinely and often”", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:22.68+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "a0ff0386-f68f-4879-b326-2bc53afa198e", "parentComponentId": null }, { "bbox": { "h": 0.15, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "paragraph", "text": "An executive at a major West Coast OPO – who we quoted earlier as refusing to do business with TransMedics due to these and other practices – corroborated the conduct described by ex-employees and other surgical staff.", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:22.68+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "bb6a4d49-4e20-4d29-b86d-84f044d02dc3", "parentComponentId": null }, { "bbox": { "h": 0.22, "w": 0.86, "x": 0.07, "y": 0.22 }, "kind": "quote", "text": "He stated that transplant patients are “routinely” skipped and denied an organ after TransMedics shows up and starts shopping organs to centers participating in its racket: “they are very high pressure...they just want somebody to use it so they get paid...so, they start making calls...they’re going down their Rolodex of their paying customers...if my mom is listed at a transplant center down the road, she doesn’t get a call...patients are being skipped routinely and often...the calls are only going to the centers that are willing to pay for these machines.”", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Pull quote", "slug": "pull-quote", "status": "active", "canonId": "019de52c-fbf9-76fe-97e1-a0b7540445c9", "version": 1, "description": null }, "framework": null }, "subkind": "pull-quote", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:22.68+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "f29a7c59-dabc-444e-8462-d9a40a3b66af", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "“They are. In a real-life scenario, what ends up happening is when an organ is declined at the last minute like that, the OPO is really charged and held responsible with the utilization of the organ...but, they are very high pressure. I think they've got two things on their mind. One is that—I am confident that they're not doing that work because they want to rescue this organ. What they want is they want to get paid...they just want somebody to use it so that they get paid...so, they start making their calls...they're going down their own Rolodex of their paying customers. If my mom is listed at a transplant center down the road, she doesn't get a call. Patients are being skipped routinely and often. The calls are only going to the centers that are willing to pay for these machines.” — Executive at a West Coast OPO, longtime industry veteran", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:10+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a97d-10227c85b58f", "parentComponentId": null }, { "bbox": { "h": 0.02, "w": 0.25, "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:22.68+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "4d328aee-c072-47d5-831a-7fe685f29ba2", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [ { "matchId": "476fb26b-78e8-4d1a-973a-577f127086f3", "evidence": "The slide frames TransMedics as a villainous entity manipulating organ allocation for profit.", "framework": null, "confidence": 0.8, "extraction": { "at": "2026-05-02 20:12:22.68+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 145, "frameworkName": "antagonist-introduction" } ], "arcBeats": [], "loops": [], "locked": true }, { "page": 146, "type": "tension", "title": "The slide uses a Q&A format to highlight potential regulatory violations by TransMedics.", "function": "expose_contradiction", "rawType": "expose_contradiction", "block": null, "metadata": { "slideType": "expose_contradiction", "slideTypeCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-124c-75aa-984a-0a3d0d8fc8df", "version": 1, "description": null }, "function": "expose_contradiction", "functionCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-171f-776f-887c-73edaff4cf9c", "version": 1, "description": null }, "density": "balanced", "densityScore": 48, "componentCount": 5, "textChars": 2743, "nDataPoints": 0, "notes": "The slide uses a Q&A format to highlight potential regulatory violations by TransMedics.", "elementsJson": [ "paragraph", "quote_block", "footnote" ], "confidence": 0.95, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:12:23.197+00", "seconds": 3.57, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/146", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-146", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "Bypassing OPTN allocation is “flat-out illegal”; discounts for organ procurement cost are an inducement", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:10+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a97c-8e5a3dec7722", "parentComponentId": null }, { "bbox": { "h": 0.35, "w": 0.86, "x": 0.07, "y": 0.15 }, "kind": "paragraph", "text": "He stated that it likely also constitutes an inducement, a separate problem for TransMedics beyond the Anti-Kickback Statute. The OIG and DOJ actively prosecute violations of the Beneficiary Inducement Statute which prohibits discounts, freebies, and items or services offered below fair market value. When the first center on the match list declines an organ, the administrator questioned if the centers that TransMedics allagedly shops the organ to are paying the full cost of the NOP procurement and transport, leaving aside the device cost - if not, as suspected, the discount or freebie would be an inducement: “they get a dry run 50% discount...what happens with the actual cost related to sending the organ back over to me? If that’s zero, then even at a discount, to be quite frank, that is an inducement.”", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:23.197+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "8086425a-6fdb-4a76-af4e-5075f15f2af5", "parentComponentId": null }, { "bbox": { "h": 0.35, "w": 0.86, "x": 0.07, "y": 0.55 }, "kind": "quote", "text": "A: “Bypassing that, that’s just not only anti-kickback, that’s going against the whole OPTN rule. So, that’s one thing. OPTN. How you allocate organs. It would just be like me turning down the organ and saying hey, by the way, I’m going to call my buddy across the street to see if he wants it...that’s just flat-out illegal. The second question I asked is whoever received that second call, are they not paying for the organ? That would be an inducement to me because here you are, that primary transplant program that was supposed to receive the initial organ that turned down the organ, they get a dry run 50% discount. Whereas either I get the organ for not free because I still have to buy the organ, the organ acquisition cost. But what happens with the actual cost related to sending the organ back over to me? If that’s zero, then even at a discount, to be quite frank, that is an inducement.” Q: “I see. So, you’re saying if there’s a scramble to place an organ somewhere, and whoever agrees to take it gets a discount or doesn’t have to pay the cost of organ procurement, they just pay for OCS or whatever, you’re saying that’s an inducement?” A: “Yeah. Take OCS out of it. Let’s go back on the match run. Okay, let’s go all the way down. Okay, I want to take it. I’m fifth in line. And then we the organ gets sent over to us. Because I’m not going to send an entire team out, right? But that procurement team is going to come over to my center. I still have to pay for that.” – Veteran transplant administrator/executive at Massachusetts General Hospital", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:23.197+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "cbd1bba7-f1f5-4e23-8c6c-b630c5db09fa", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "“Bypassing that, that’s just not only anti-kickback, that’s going against the whole OPTN rule...that’s just flat-out illegal.” — Veteran transplant administrator/executive at Massachusetts General Hospital", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:10+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a97c-9324c3a0d548", "parentComponentId": null }, { "bbox": { "h": 0.03, "w": 0.3, "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:23.197+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "f9c60d22-0e1f-4f20-b062-28055b6d37cb", "parentComponentId": null } ], "metrics": [], "tools": [ { "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null, "categoryName": null, "categorySlug": null }, "agent": null, "layer": "slide", "agents": null, "matchId": "f3af15c0-db10-4d13-8ac5-0de3d6d386d1", "evidence": "The quote is attributed to a 'Veteran transplant administrator/executive at Massachusetts General Hospital'.", "pageRefs": null, "priority": null, "whenToUse": null, "confidence": 0.7, "extraction": { "at": "2026-07-16 23:10:35.040841+00", "model": "or:meta-llama/llama-4-scout", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 146, "whyItWorks": null, "antipattern": null, "cardinality": "common", "narrativePurpose": null } ], "frameworks": [], "arcBeats": [], "loops": [], "locked": true }, { "page": 147, "type": "tension", "title": "The slide uses a combination of summary text and a direct quote from a high-volume user to substantiate the claim of unethical organ allocation practices.", "function": "expose_contradiction", "rawType": "expose_contradiction", "block": null, "metadata": { "slideType": "expose_contradiction", "slideTypeCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-124c-75aa-984a-0a3d0d8fc8df", "version": 1, "description": null }, "function": "expose_contradiction", "functionCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-171f-776f-887c-73edaff4cf9c", "version": 1, "description": null }, "density": "dense", "densityScore": 56, "componentCount": 6, "textChars": 4286, "nDataPoints": 0, "notes": "The slide uses a combination of summary text and a direct quote from a high-volume user to substantiate the claim of unethical organ allocation practices.", "elementsJson": [ "paragraph", "quote_block", "footnote" ], "confidence": 0.95, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:12:24.014+00", "seconds": 4.329, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/147", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-147", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": { "h": 0.03, "w": 0.86, "x": 0.07, "y": 0.55 }, "kind": "callout", "text": "Open secret among high volume TransMedics users that the organ allocation process is bypassed", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": null, "subkind": { "name": "Primary callout", "slug": "primary", "status": "active", "canonId": "019de52c-fbd1-70eb-a9ce-8997f8674c1d", "version": 1, "description": null }, "framework": null }, "subkind": "primary", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:24.014+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "4933eec1-e063-4793-8b60-9abb613f80aa", "parentComponentId": null }, { "bbox": { "h": 0.25, "w": 0.86, "x": 0.07, "y": 0.23 }, "kind": "paragraph", "text": "A transplant chief described a large meeting held by Transmedics – “the leaders of many transplant programs were invited…I was one of them” – where the problem of hijacking the OPTN list was acknowledged – but behind closed doors. We emphasize that this surgeon appears to benefit from the scheme: “calling TransMedics experienced users and saying…’would you be interested?’…[redacted] got up to the podium at that meeting and said…do it under OPTN guidelines, do not bypass the list…the OPO where that liver was procured should be the one to go down the central list…it should not be TransMedics calling UCSD, another super-user, and saying, hey [surgeon name redacted], would have you have a patient….”", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:24.014+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "009a4a30-0e8f-48a2-9de5-1ca7c50fd09c", "parentComponentId": null }, { "bbox": { "h": 0.35, "w": 0.86, "x": 0.07, "y": 0.58 }, "kind": "quote", "text": "“TransMedics held this in-person meeting in Boston right before the American College of Surgeons last year. The leaders of many transplant programs were invited; I was one of them…and at that meeting, this very issue was discussed, this concept of bypassing the list…so, a center that is not normally accustomed to using the liver on pump, they’re not going to take a liver like that. And time is important to figure out who you would use the graft for…calling TransMedics experienced users and saying, the primary center we procured for no longer wants to use this graft. Would you be interested?” So, [redacted] got up to the podium at that meeting and said, I understand why you are doing this…make sure that you do it under OPTN guidelines, do not bypass the list. And everybody in the room was in agreement…I get the practice that they’re talking about. What should happen, for example, the liver I just told you about where we decided not to use it, what should happen is the OPO where that liver was procured should be the one to go down the central list and say the next patient on the list is a patient from [redacted]. Let’s call [redacted] and explain the situation and see if they are willing to use. It should not be TransMedics calling [redacted], another super-user, and saying, hey [surgeon name redacted], would you have a patient on your list? The OPO should be the one to say the next patient on the list is from [redacted], and then reach out to the surgeon and say your patient is next on the list. Would you be willing to use this liver?” – Transplant surgeon; high volume user", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:24.014+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "b81331bc-1830-45e1-9286-b3646fba5b70", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "“TransMedics held this in-person meeting in Boston right before the American College of Surgeons last year. The leaders of many transplant programs were invited; I was one of them...and at that meeting, this very issue was discussed, this concept of bypassing the list...so, a center that is not normally accustomed to using the liver on pump, they’re not going to take a liver like that. And time is important to figure out who you would use the graft for...calling TransMedics experienced users and saying, the primary center we procured for no longer wants to use this graft. Would you be interested?” So, [redacted] got up on the podium at that meeting and said, I understand why you are doing this...make sure that you do it under OPTN guidelines, do not bypass the list. And everybody in the room was in agreement...I get the practice that they’re talking about. What should happen, for example, the liver I just told you about where we decided not to use it, what should happen is the OPO where that liver was procured should be the one to go down the central list and say the next patient on the list is a patient from [redacted]. Let’s call [redacted] and explain the situation and see if they are willing to use. It should not be TransMedics calling [redacted], another super-user, and saying, hey [surgeon name redacted], would you have a patient on your list? The OPO should be the one to say the next patient on the list is from [redacted], and then reach out to the surgeon and say your patient is next on the list. Would you be willing to use this liver?” — Transplant surgeon; high volume user", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:10+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a97d-83e0a1f97378", "parentComponentId": null }, { "bbox": { "h": 0.02, "w": 0.3, "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:24.014+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "aeeba83d-20c1-4a8e-b08c-ff905844ef46", "parentComponentId": null }, { "bbox": { "h": 0.15, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "title", "text": "Multiple TransMedics “super users” indicated that the company bypasses OPTN rules to allegedly take over the organ allocation process from OPO’s in order to preferentially offer them organs – already on the device, naturally.", "attrs": null, "canon": { "kind": { "name": "Title", "slug": "title", "status": "active", "canonId": "019de52c-f7dd-76d9-b848-b1f12bd85cf4", "version": 1, "description": "Slide title or headline." }, "tool": null, "subkind": { "name": "Headline", "slug": "headline", "status": "active", "canonId": "019de52c-fae1-7463-9a7c-d60668eced0d", "version": 1, "description": null }, "framework": null }, "subkind": "headline", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:24.014+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "62977ddd-88e5-49e8-a530-749f8e56796a", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [ { "matchId": "d7725ef3-8a1c-41e7-a1ab-df814fbc8957", "evidence": "The slide explicitly details an alleged scheme to bypass regulatory (OPTN) guidelines for commercial gain.", "framework": null, "confidence": 0.9, "extraction": { "at": "2026-05-02 20:12:24.014+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 147, "frameworkName": "fraud-exposure" } ], "arcBeats": [], "loops": [], "locked": true }, { "page": 148, "type": "tension", "title": "The slide uses a Q&A format to highlight alleged unethical business practices.", "function": "expose_contradiction", "rawType": "expose_contradiction", "block": null, "metadata": { "slideType": "expose_contradiction", "slideTypeCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-124c-75aa-984a-0a3d0d8fc8df", "version": 1, "description": null }, "function": "expose_contradiction", "functionCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-171f-776f-887c-73edaff4cf9c", "version": 1, "description": null }, "density": "dense", "densityScore": 53, "componentCount": 6, "textChars": 2402, "nDataPoints": 0, "notes": "The slide uses a Q&A format to highlight alleged unethical business practices.", "elementsJson": [ "paragraph", "quote_block", "footnote" ], "confidence": 0.9, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:12:23.032+00", "seconds": 3.215, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/148", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-148", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": { "h": 0.25, "w": 0.86, "x": 0.07, "y": 0.55 }, "kind": "callout", "text": "TransMedics allegedly “bullied” OPO for Improper access to DonorNet\nA: “I work with our OPO pretty closely. I know a lot of the senior leaders there. They also really despise TransMedics, and were not interested in it - they did feel like they were being bullied. They wanted their unit access to Donor Net so they could see all of the donors that were coming that were part of the [OPO name redacted] service area so they could monitor them and have this insider view of potential organs for the device. They really didn’t like that, and they were pushing back. It kind of soured the relationship.”\nQ: “TransMedics is pushing for access to Donor Net—that’s this US organ allocation system?”\nA: “Yeah, exactly.” – Transplant administrator", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": null, "subkind": { "name": "Primary callout", "slug": "primary", "status": "active", "canonId": "019de52c-fbd1-70eb-a9ce-8997f8674c1d", "version": 1, "description": null }, "framework": null }, "subkind": "primary", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:23.032+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "321bf7d1-3847-4ade-ac10-3e3263a360b9", "parentComponentId": null }, { "bbox": null, "kind": "callout", "text": "A transplant administrator at a pre-eminent center, one of the highest volume in the world, alleged that TransMedics attempted to \"bully\" the local OPO into granting them credentials to log into DonorNet, which they have allegedly obtained via another OPO.", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:10+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a97d-3d552822192e", "parentComponentId": null }, { "bbox": { "h": 0.25, "w": 0.86, "x": 0.07, "y": 0.22 }, "kind": "paragraph", "text": "Multiple sources told us that TransMedics has essentially infiltrated the system to obtain an “insider view of potential organs for the device.” A transplant administrator at a pre-eminent center, one of the highest volume in the world, alleged that TransMedics attempted to “bully” the local OPO into granting them credentials to log into DonorNet, which they have allegedly obtained via another OPO: “I work with our OPO pretty closely...they also really despise TransMedics...they were being bullied...they wanted their unit access to DonorNet so they could see all of the donors...that were part of the [OPO name redacted] service area....they really didn’t like that...they were pushing back...it kind of soured the relationship.”", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:23.032+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "0106f09b-0b4c-4b3d-9df9-74cfe3898227", "parentComponentId": null }, { "bbox": { "h": 0.15, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "paragraph", "text": "A key component of what we believe to be an organ steering scheme involves what we interpret as improper access to DonorNet, the national system used by OPO’s and managed by UNOS to generate match runs and the ranked list of potential transplant recipients.", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:23.032+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "bae433a3-e4a3-497a-93c8-de1a85bad32c", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "\"I work with our OPO pretty closely...they also really despise TransMedics...they were being bullied...they wanted their unit access to DonorNet so they could see all of the donors...that were part of the [OPO name redacted] service area....they really didn't like that...they were pushing back...it kind of soured the relationship.\" — Transplant administrator", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:10+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a97d-42c256a92cef", "parentComponentId": null }, { "bbox": { "h": 0.02, "w": 0.3, "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:23.032+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "497a04f8-283b-4290-b117-efc324fe3bec", "parentComponentId": null } ], "metrics": [], "tools": [ { "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null, "categoryName": null, "categorySlug": null }, "agent": null, "layer": "slide", "agents": null, "matchId": "7e5f944e-e998-4660-b5c7-d132b1fa001c", "evidence": "The allegations are attributed to multiple sources, including a transplant administrator.", "pageRefs": null, "priority": null, "whenToUse": null, "confidence": 0.7, "extraction": { "at": "2026-07-16 23:10:35.161051+00", "model": "or:meta-llama/llama-4-scout", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 148, "whyItWorks": null, "antipattern": null, "cardinality": "common", "narrativePurpose": null } ], "frameworks": [], "arcBeats": [], "loops": [], "locked": true }, { "page": 149, "type": "tension", "title": "The slide uses screenshots of the UNOS/UNet portal to establish the system's official status and legal warnings.", "function": "expose_contradiction", "rawType": "expose_contradiction", "block": null, "metadata": { "slideType": "expose_contradiction", "slideTypeCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-124c-75aa-984a-0a3d0d8fc8df", "version": 1, "description": null }, "function": "expose_contradiction", "functionCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-171f-776f-887c-73edaff4cf9c", "version": 1, "description": null }, "density": "balanced", "densityScore": 33, "componentCount": 6, "textChars": 817, "nDataPoints": 0, "notes": "The slide uses screenshots of the UNOS/UNet portal to establish the system's official status and legal warnings.", "elementsJson": [ "paragraph", "screenshot", "footnote" ], "confidence": 0.95, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:12:25.038+00", "seconds": 5.142, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/149", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-149", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "The system appears to be property of the US government, which we presume would create far more serious legal jeopardy for TransMedics than infiltrating a private network, if the allegations are true.", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:10+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a97c-5b73ba126a3f", "parentComponentId": null }, { "bbox": { "h": 0.48, "w": 0.86, "x": 0.07, "y": 0.45 }, "kind": "image", "text": "UNOS website interface showing DonorNet functionality and login screen", "attrs": null, "canon": { "kind": { "name": "Image", "slug": "image", "status": "active", "canonId": "019de52c-f978-701f-a720-51d029d769e7", "version": 1, "description": "Photo, illustration, screenshot or icon." }, "tool": null, "subkind": { "name": "Screenshot", "slug": "screenshot", "status": "active", "canonId": "019de52c-fd87-7509-8391-3d79fb339379", "version": 1, "description": null }, "framework": null }, "subkind": "screenshot", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:25.038+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "84e1da9e-25f2-47f7-9174-0392c179d52b", "parentComponentId": null }, { "bbox": { "h": 0.25, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "paragraph", "text": "The UNOS website indicates the broad role DonorNet plays in running the national organ transplant system... The system appears to be property of the US government, which we presume would create far more serious legal jeopardy for TransMedics...", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:25.038+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "f77cf1dc-b380-4285-a432-0a8a1f817cef", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "this system is a U.S. Government-designated Federal Information System operated by a contractor of an executive agency...unauthorized use of the system is prohibited and subject to civil and criminal penalties. — UNOS website", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:10+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a97c-5cfa8f62a464", "parentComponentId": null }, { "bbox": { "h": 0.02, "w": 0.2, "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: https://unos.org/technology/unet/", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:25.038+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "6316628d-681a-44d8-bcef-8c0ac4202ff2", "parentComponentId": null }, { "bbox": { "h": 0.03, "w": 0.3, "x": 0.07, "y": 0.41 }, "kind": "title", "text": "DonorConnect overview and login screen", "attrs": null, "canon": { "kind": { "name": "Title", "slug": "title", "status": "active", "canonId": "019de52c-f7dd-76d9-b848-b1f12bd85cf4", "version": 1, "description": "Slide title or headline." }, "tool": null, "subkind": { "name": "Headline", "slug": "headline", "status": "active", "canonId": "019de52c-fae1-7463-9a7c-d60668eced0d", "version": 1, "description": null }, "framework": null }, "subkind": "headline", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:25.038+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "a372fdf0-1e4f-4d34-ae12-7695bf35d28e", "parentComponentId": null } ], "metrics": [], "tools": [ { "tool": { "name": "Slide visual craft", "slug": "visual-craft", "status": "active", "bestFor": null, "canonId": "019df269-2d56-7739-ab65-cc2e091a109b", "version": 1, "bodyDocId": "019df269-2d32-736a-ae59-0250c5540c9a", "description": "What separates a 5/5-visual-craft deck from a 3/5 one.", "familyLabel": "slide-recipe", "categoryName": "Slide", "categorySlug": "slide" }, "agent": "designer", "layer": "slide", "agents": [ "designer" ], "matchId": "ef0e0155-84df-4485-a7d0-8e8bebc47532", "evidence": "The slide includes an image of the UNOS website interface showing DonorNet functionality and login screen.", "pageRefs": null, "priority": null, "whenToUse": null, "confidence": 0.7, "extraction": { "at": "2026-07-16 23:10:35.242709+00", "model": "or:meta-llama/llama-4-scout", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 149, "whyItWorks": null, "antipattern": null, "cardinality": null, "narrativePurpose": null } ], "frameworks": [], "arcBeats": [], "loops": [], "locked": true }, { "page": 150, "type": "tension", "title": "The slide uses a Q&A transcript format to highlight potential ethical concerns regarding vendor access to sensitive medical data.", "function": "expose_contradiction", "rawType": "expose_contradiction", "block": null, "metadata": { "slideType": "expose_contradiction", "slideTypeCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-124c-75aa-984a-0a3d0d8fc8df", "version": 1, "description": null }, "function": "expose_contradiction", "functionCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-171f-776f-887c-73edaff4cf9c", "version": 1, "description": null }, "density": "balanced", "densityScore": 49, "componentCount": 5, "textChars": 2999, "nDataPoints": 0, "notes": "The slide uses a Q&A transcript format to highlight potential ethical concerns regarding vendor access to sensitive medical data.", "elementsJson": [ "paragraph", "quote_block", "footnote" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:12:24.029+00", "seconds": 3.925, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/150", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-150", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "Access to DonorNet would allow TransMedics to view patient medical information and the ability to steer cases onto its device.", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:10+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a97d-276edf1a20b6", "parentComponentId": null }, { "bbox": { "h": 0.52, "w": 0.86, "x": 0.07, "y": 0.41 }, "kind": "paragraph", "text": "TransMedics allegedly has a login to DonorNet\nQ: “Why did they want access to that system? That seems highly inappropriate.”\nA: “Yeah, it is inappropriate, and they weren’t granted access, thankfully. But I think what they wanted to see was—because every time a new potential donor becomes available, someone at the OPO is entering that data into this computer system. You can see at any given time which donors are in the pipe, which ones are in the cue. And so, they probably, I would imagine they wanted to go and review their clinical information to see if they might be a good candidate for the device. I don’t know what they were going to do with that information, like try to persuade the OPO or try to persuade the surgeon at the transplant center that accepted it; I don’t know.”\nQ: “Do you think they have—they must have access to Donor Net through other OPOs that they’re close to?”\nA: “That’s all easy to - yeah, they might. You have to have a business code. You have to be a vendor in the UNOS system to be able to assign access to you. I’m sure they have a code. Anyone could look and see who they have access to. It’s not something that’s transparent. Although, I suppose an OPO could give a vendor access through their own login.” – Transplant administrator", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:24.029+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "0b872f27-e2fe-4dde-9329-075b86949fb6", "parentComponentId": null }, { "bbox": { "h": 0.35, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "paragraph", "text": "The transplant executive stated that “yeah, it is inappropriate and they weren’t granted access, thankfully” – at least by that OPO. Access to DonorNet would allow TransMedics to view patient medical information and the ability to steer cases onto its device: “you can see at any given times which donors are in the pipe...they wanted to go and review their clinical information to see if they might be a good candidate for the device...to persuade the OPO or try to persuade the surgeon at the transplant center that accepted it...I’m sure they have a code...it’s not something that’s transparent...an OPO could give a vendor access through their own login.”", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:24.029+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "d6d410ef-ff6a-4378-b8a6-e61946defdb2", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "Yeah, it is inappropriate, and they weren’t granted access, thankfully. But I think what they wanted to see was—because every time a new potential donor becomes available, someone at the OPO is entering that data into this computer system. You can see at any given time which donors are in the pipe, which ones are in the cue. And so, they probably, I would imagine they wanted to go and review their clinical information to see if they might be a good candidate for the device. I don’t know what they were going to do with that information, like try to persuade the OPO or try to persuade the surgeon at the transplant center that accepted it; I don’t know. ... I’m sure they have a code. Anyone could look and see who they have access to. It’s not something that’s transparent. Although, I suppose an OPO could give a vendor access through their own login. — Transplant administrator", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:10+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a97d-2b0266db8bbb", "parentComponentId": null }, { "bbox": { "h": 0.02, "w": 0.3, "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:24.029+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "5c47e9e9-ce01-487f-8d8f-0af41a96b2e9", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [], "arcBeats": [], "loops": [], "locked": true }, { "page": 151, "type": "tension", "title": "The slide presents two Q&A excerpts from a transplant surgeon to support the claim that TransMedics is hijacking the organ allocation process.", "function": "expose_contradiction", "rawType": "expose_contradiction", "block": null, "metadata": { "slideType": "expose_contradiction", "slideTypeCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-124c-75aa-984a-0a3d0d8fc8df", "version": 1, "description": null }, "function": "expose_contradiction", "functionCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-171f-776f-887c-73edaff4cf9c", "version": 1, "description": null }, "density": "dense", "densityScore": 69, "componentCount": 8, "textChars": 2454, "nDataPoints": 0, "notes": "The slide presents two Q&A excerpts from a transplant surgeon to support the claim that TransMedics is hijacking the organ allocation process.", "elementsJson": [ "paragraph", "quote_block" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:12:27.806+00", "seconds": 7.625, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/151", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-151", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "TransMedics has allegedly already penetrated Donor Net to hijack the organ allocation process", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:10+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a97d-6a18f99cf05c", "parentComponentId": null }, { "bbox": { "h": 0.05, "w": 0.86, "x": 0.07, "y": 0.35 }, "kind": "paragraph", "text": "Allegedly accessing Donor Net and “calling around” to offer the organ and bypass the organ", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:27.806+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "10a58dcf-ba7f-4bdd-ab0f-07406f02f398", "parentComponentId": null }, { "bbox": { "h": 0.05, "w": 0.86, "x": 0.07, "y": 0.63 }, "kind": "paragraph", "text": "TransMedics has allegedly already penetrated Donor Net to hijack the organ allocation process", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:27.806+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "927c75cb-46c0-427e-bf13-444c22b85149", "parentComponentId": null }, { "bbox": { "h": 0.2, "w": 0.86, "x": 0.07, "y": 0.41 }, "kind": "quote", "text": "Q: “I heard they were trying to badger an OPO to give them access to Donor Net.” A: “Yeah. They should not be allowed to have access to Donor Net. And I know that really certainly pisses off some OPOs when, for example, you get a situation where a transplant center turns down a liver that TransMedics has arrived to recover. And the TransMedics people start calling around to other surgeons, other programs, saying there’s a liver out there. Do you want to take it? And the OPOs are like, you can’t do that; that’s our job. We’ll allocate the organ; don’t be making these phone calls.” - Transplant surgeon at a high volume academic center", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:27.806+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "a06f286f-acf2-44a3-beab-75bc12aa400a", "parentComponentId": null }, { "bbox": { "h": 0.2, "w": 0.86, "x": 0.07, "y": 0.69 }, "kind": "quote", "text": "Q: “Are there ways that they could be leveraging their relationship with these OPOs - Nevada, Massachusetts - to do things like look at Donor Net, do things like jumping the line.” A: “Let’s say we have a scenario where we have a rapid DCD. We’re just going to put this liver on the machine and then allocate it. And then you have to take it on the machine and you have to pay for it. In Donor Net, you’ll see when you get an organ offer, and you look at there’s like a little blurb, the blurb will often say TransMedics is active in this area and can be utilized for organ recovery. So, they’ve already inserted themselves.“ - Transplant surgeon at a high volume academic center", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:27.806+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "d26bded3-4cda-4fb5-a4e5-f1bcd755a271", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "Yeah. They should not be allowed to have access to Donor Net. And I know that really certainly pisses off some OPOs when, for example, you get a situation where a transplant center turns down a liver that TransMedics has arrived to recover. And the TransMedics people start calling around to other surgeons, other programs, saying there’s a liver out there. Do you want to take it? And the OPOs are like, you can’t do that; that’s our job. We’ll allocate the organ; don’t be making these phone calls. — Transplant surgeon at a high volume academic center", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:10+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a97d-6daba756a743", "parentComponentId": null }, { "bbox": { "h": 0.03, "w": 0.3, "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:27.806+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "6c264e77-6a7a-47cd-be47-ee2d53e59067", "parentComponentId": null }, { "bbox": { "h": 0.25, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "title", "text": "A TransMedics “super user” and one we consider to be a willing participant in their organ steering scheme – was nonetheless candid about the company’s use of DonorNet to improperly shop organs and bypass the OPO’s ranked list of potential recipients", "attrs": null, "canon": { "kind": { "name": "Title", "slug": "title", "status": "active", "canonId": "019de52c-f7dd-76d9-b848-b1f12bd85cf4", "version": 1, "description": "Slide title or headline." }, "tool": null, "subkind": { "name": "Headline", "slug": "headline", "status": "active", "canonId": "019de52c-fae1-7463-9a7c-d60668eced0d", "version": 1, "description": null }, "framework": null }, "subkind": "headline", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:27.806+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "804c8e78-09d0-455c-9a3c-2de1390743d3", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [], "arcBeats": [], "loops": [], "locked": true }, { "page": 152, "type": "tension", "title": "The slide uses direct quotes from industry experts to build a case against TransMedics' business practices.", "function": "expose_contradiction", "rawType": "expose_contradiction", "block": null, "metadata": { "slideType": "expose_contradiction", "slideTypeCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-124c-75aa-984a-0a3d0d8fc8df", "version": 1, "description": null }, "function": "expose_contradiction", "functionCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-171f-776f-887c-73edaff4cf9c", "version": 1, "description": null }, "density": "balanced", "densityScore": 45, "componentCount": 7, "textChars": 999, "nDataPoints": 0, "notes": "The slide uses direct quotes from industry experts to build a case against TransMedics' business practices.", "elementsJson": [ "paragraph", "quote_block", "footnote" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:12:23.852+00", "seconds": 3.254, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/152", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-152", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "we lost trust in their business practices...that is a violation of the data use agreement that UNOS requires us all to commit to.", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:10+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a97c-decece037d70", "parentComponentId": null }, { "bbox": { "h": 0.15, "w": 0.86, "x": 0.07, "y": 0.45 }, "kind": "list", "text": "Allegedly pushing for access into DonorNet to \"go through the chart\"", "attrs": null, "canon": { "kind": { "name": "List", "slug": "list", "status": "active", "canonId": "019de52c-f94b-779b-a53b-fd4904a5f4d2", "version": 1, "description": "Bullet or numbered list." }, "tool": null, "subkind": { "name": "Bullet list", "slug": "bullet", "status": "active", "canonId": "019de52c-fc98-7169-a083-5cab805076ca", "version": 1, "description": null }, "framework": null }, "subkind": "bullet", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:23.852+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "3ed13ab8-1d5e-461e-9509-44a1d9ce8354", "parentComponentId": null }, { "bbox": { "h": 0.25, "w": 0.86, "x": 0.07, "y": 0.68 }, "kind": "list", "text": "Allegedly obtained access via their local New England OPO; \"violation of the data use agreement\"", "attrs": null, "canon": { "kind": { "name": "List", "slug": "list", "status": "active", "canonId": "019de52c-f94b-779b-a53b-fd4904a5f4d2", "version": 1, "description": "Bullet or numbered list." }, "tool": null, "subkind": { "name": "Bullet list", "slug": "bullet", "status": "active", "canonId": "019de52c-fc98-7169-a083-5cab805076ca", "version": 1, "description": null }, "framework": null }, "subkind": "bullet", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:23.852+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "9a22820a-f692-44d7-8eba-7da6daba073a", "parentComponentId": null }, { "bbox": { "h": 0.15, "w": 0.86, "x": 0.07, "y": 0.22 }, "kind": "paragraph", "text": "The executive speculated that the New England OPO, led by a controversial CEO who we were told is close to TransMedics CEO, provided a login, which would provide the company access to the most sensitive patient data on a national basis.", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:23.852+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "f6556674-3655-42e6-81a9-854c8f36122c", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "“Yeah, they tried to do that with us...TransMedics wanted access to that. And so what they were saying to the OPO's, give me access as if I were your employee. Register me in the system, give me a password; we just want to help you.” — Executive at a West Coast OPO, longtime industry veteran", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:10+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a97c-e2baaa8d406c", "parentComponentId": null }, { "bbox": { "h": 0.03, "w": 0.3, "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:23.852+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "a93a0a45-1164-4cb7-b7e5-2dc88a72e0fe", "parentComponentId": null }, { "bbox": { "h": 0.15, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "title", "text": "An executive at one of the largest OPO's in the country detailed how TransMedics tried to push them for access to DonorNet", "attrs": null, "canon": { "kind": { "name": "Title", "slug": "title", "status": "active", "canonId": "019de52c-f7dd-76d9-b848-b1f12bd85cf4", "version": 1, "description": "Slide title or headline." }, "tool": null, "subkind": { "name": "Headline", "slug": "headline", "status": "active", "canonId": "019de52c-fae1-7463-9a7c-d60668eced0d", "version": 1, "description": null }, "framework": null }, "subkind": "headline", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:23.852+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "4fcbe9c2-09e8-4682-aa38-a76e038534f5", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [ { "matchId": "5aeb820b-1e3c-4c18-b0fc-4ca1b5275509", "evidence": "The slide explicitly frames the narrative around a potential violation of data use agreements and unauthorized access to sensitive patient data.", "framework": null, "confidence": 0.9, "extraction": { "at": "2026-05-02 20:12:23.852+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 152, "frameworkName": "fraud-exposure" } ], "arcBeats": [], "loops": [], "locked": true }, { "page": 153, "type": "tension", "title": "The slide uses a Q&A format to highlight potential misuse of system access.", "function": "expose_contradiction", "rawType": "ceo_quote", "block": null, "metadata": { "slideType": "ceo_quote", "slideTypeCanon": { "name": "CEO quote", "slug": "ceo_quote", "status": "active", "canonId": "019de52d-09b6-71c8-93a5-f90a9772a8fa", "version": 1, "description": null }, "function": "expose_contradiction", "functionCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-171f-776f-887c-73edaff4cf9c", "version": 1, "description": null }, "density": "balanced", "densityScore": 48, "componentCount": 5, "textChars": 2575, "nDataPoints": 0, "notes": "The slide uses a Q&A format to highlight potential misuse of system access.", "elementsJson": [ "paragraph", "quote_block", "footnote" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:12:25.654+00", "seconds": 4.832, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/153", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-153", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "It could essentially be giving them a competitive advantage, if you can go in there and see what center has all the top listed, the sickest liver patients.", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:10+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a97d-94ffb115919f", "parentComponentId": null }, { "bbox": { "h": 0.552, "w": 0.854, "x": 0.073, "y": 0.345 }, "kind": "paragraph", "text": "DonorNet access provides “broadest level of access” and a competitive advantage\nQ: “And how could they be abusing this?”\nA: “For a while, they were going in with the access that they had from another OPO. It depends on what sorts of permissions that OPO has and how tightly they’re monitoring the privileges that they grant. But the system is not really designed to let a third-party company into this, and once they’re in, they’re in, and the OPOs typically have the broadest level of access. They could be saving information. There’s patient-level information in there. Potential recipients, where they are. It could essentially be giving them a competitive advantage, if you can go in there and see what center has all the top listed, the sickest liver patients. I imagine that might give them an advantage as a vendor over the competition about which next transplant center you might go out and try to court to be a client of yours.” – Executive at a West Coast OPO, longtime industry veteran", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:25.654+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "7503a769-5be4-4e29-b408-ff7d1d073a67", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "“For a while, they were going in with the access that they had from another OPO. It depends on what sorts of permissions that OPO has and how tightly they’re monitoring the privileges that they grant. But the system is not really designed to let a third-party company into this, and once they’re in, they’re in, and the OPOs typically have the broadest level of access. They could be saving information. There’s patient-level information in there. Potential recipients, where they are. It could essentially be giving them a competitive advantage, if you can go in there and see what center has all the top listed, the sickest liver patients. I imagine that might give them an advantage as a vendor over the competition about which next transplant center you might go out and try to court.” — Executive at a West Coast OPO, longtime industry veteran", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:10+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a97d-980b425ba535", "parentComponentId": null }, { "bbox": { "h": 0.015, "w": 0.235, "x": 0.073, "y": 0.948 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:25.654+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "24a817d1-52bf-4627-abbe-9259760603d3", "parentComponentId": null }, { "bbox": { "h": 0.215, "w": 0.854, "x": 0.073, "y": 0.069 }, "kind": "title", "text": "The OPO executive explained that a DonorNet login would provide TransMedics with “the broadest level of access...they could be saving information” – “they system is not really designed to let a third-party company into this...once they’re in, they’re in...there’s patient-level information in there...potential recipients, where they are...it could essentially be giving them a competitive advantage...an advantage as a vendor over the competition about which next transplant center you might go out and try to court...”", "attrs": null, "canon": { "kind": { "name": "Title", "slug": "title", "status": "active", "canonId": "019de52c-f7dd-76d9-b848-b1f12bd85cf4", "version": 1, "description": "Slide title or headline." }, "tool": null, "subkind": { "name": "Headline", "slug": "headline", "status": "active", "canonId": "019de52c-fae1-7463-9a7c-d60668eced0d", "version": 1, "description": null }, "framework": null }, "subkind": "headline", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:25.654+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "629f97a1-5435-4ee3-909d-2f04e60655a2", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [], "arcBeats": [], "loops": [], "locked": true }, { "page": 154, "type": "tension", "title": "Includes a direct quote from an unnamed source regarding the company's technicians.", "function": "name_villain", "rawType": "villain_critique", "block": null, "metadata": { "slideType": "villain_critique", "slideTypeCanon": { "name": "Villain critique", "slug": "villain_critique", "status": "active", "canonId": "019de52d-10bc-7136-bf20-09de59d17447", "version": 1, "description": null }, "function": "name_villain", "functionCanon": { "name": "Name villain", "slug": "name_villain", "status": "active", "canonId": "019de52d-1746-70d6-bc58-5eeaf5865526", "version": 1, "description": null }, "density": "sparse", "densityScore": 16, "componentCount": 3, "textChars": 636, "nDataPoints": 0, "notes": "Includes a direct quote from an unnamed source regarding the company's technicians.", "elementsJson": [ "paragraph" ], "confidence": 0.95, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:12:23.044+00", "seconds": 1.94, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/154", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-154", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "Part 6. TransMedics device usage is, we conclude, almost all off-label, the largest such racket we have encountered, putting it at existential risk: “I’ve never seen a device manufacturer so boldly engage in off-label use themselves…it’s their technician.”", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:10+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a97c-a5f4342fccb5", "parentComponentId": null }, { "bbox": { "h": 0.135, "w": 0.854, "x": 0.073, "y": 0.069 }, "kind": "paragraph", "text": "Part 6. TransMedics device usage is, we conclude, almost all off-label, the largest such racket we have encountered, putting it at existential risk: “I’ve never seen a device manufacturer so boldly engage in off-label use themselves…it’s their technician.”", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:23.044+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "4fe62741-6e5d-463a-9090-176ae7803035", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "“I’ve never seen a device manufacturer so boldly engage in off-label use themselves…it’s their technician.” — Unnamed source", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:10+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a97c-aa56d58cce73", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [ { "matchId": "2d800cb0-186e-4e96-86b8-1d15ef3f0a25", "evidence": "The slide frames the company as a 'racket' and identifies an existential risk, positioning them as the villain in the research narrative.", "framework": null, "confidence": 0.9, "extraction": { "at": "2026-05-02 20:12:23.044+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 154, "frameworkName": "antagonist-introduction" } ], "arcBeats": [], "loops": [], "locked": true }, { "page": 155, "type": "tension", "title": "The slide uses a 'fraud-exposure' framework to contrast alleged real-world usage with official FDA labeling.", "function": "expose_contradiction", "rawType": "expose_contradiction", "block": null, "metadata": { "slideType": "expose_contradiction", "slideTypeCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-124c-75aa-984a-0a3d0d8fc8df", "version": 1, "description": null }, "function": "expose_contradiction", "functionCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-171f-776f-887c-73edaff4cf9c", "version": 1, "description": null }, "density": "overcrowded", "densityScore": 82, "componentCount": 9, "textChars": 2666, "nDataPoints": 2, "notes": "The slide uses a 'fraud-exposure' framework to contrast alleged real-world usage with official FDA labeling.", "elementsJson": [ "paragraph", "callout_box" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:12:24.83+00", "seconds": 3.679, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/155", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-155", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "In our opinion, payors – the government and a few private ones – are defrauded out of $100,000 to $400,000 per case with NOP charges, under false pretenses, to improve surgeon lifestyles.", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:10+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a97d-57f32c65ec68", "parentComponentId": null }, { "bbox": { "h": 0.12, "w": 0.86, "x": 0.07, "y": 0.47 }, "kind": "paragraph", "text": "In our opinion, payors – the government and a few private ones – are defrauded out of $100,000 to $400,000 per case with NOP charges, under false pretenses, to improve surgeon lifestyles. The indication on the label is exclusively clinical, using OCS liver as an example.", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:24.83+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "05a2ce54-c93a-4d28-bfd1-b1934682d78c", "parentComponentId": null }, { "bbox": { "h": 0.22, "w": 0.8, "x": 0.13, "y": 0.69 }, "kind": "paragraph", "text": "The TransMedics® Organ Care System (OCS™) Liver is a portable extracorporeal liver perfusion and monitoring system indicated for preservation and monitoring of hemodynamics and metabolic function which allows for ex vivo assessment of liver allografts from donors after brain death (DBD) or liver allografts from donors after circulatory death (DCD) ≤55 years old and with ≤30 mins of warm ischemic time, macrosteatosis ≤15%, in a near-physiologic, normothermic and functioning state intended for a potential transplant recipient.", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:24.83+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "7e8556ec-9094-48c7-9944-a466a0bb2b89", "parentComponentId": null }, { "bbox": { "h": 0.15, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "paragraph", "text": "Upon extensive research, we conclude that the vast majority of TransMedics device usage is off-label, to such an extreme degree that we believe it to be the largest off-label racket we have ever encountered and likely one of the largest in US medical device history.", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:24.83+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "c1622bad-9c3b-4b2d-8666-4b28064c51ed", "parentComponentId": null }, { "bbox": { "h": 0.25, "w": 0.86, "x": 0.07, "y": 0.22 }, "kind": "paragraph", "text": "The purported purpose of the pump is clinical – to preserve and assess organs during transportation to increase their utilization and improve outcomes. However, according to dozens of interviews with ex-employees, large OPO’s, and the transplant surgeons and centers who are its highest volume users - who were unusually transparent with us - the primary use case is non-clinical, with no clinical benefit: scheduling and convenience for surgeons and OR staff, who park organs on the pump for highly prolonged periods to stack cases and avoid late night work.", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:24.83+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "cb8d877b-a75b-4668-b8ae-1937f214eab9", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "The TransMedics® Organ Care System (OCS™) Liver is a portable extracorporeal liver perfusion and monitoring system indicated for preservation and monitoring of hemodynamics and metabolic function which allows for ex vivo assessment of liver allografts from donors after brain death (DBD) or liver allografts from donors after circulatory death (DCD) ≤55 years old and with ≤30 mins of warm ischemic time, macrosteatosis ≤15%, in a near-physiologic, normothermic and functioning state intended for a potential transplant recipient. — FDA PMA Approval Order Statement, Summary of Safety and Effectiveness Data – Sept 28, 2021", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:10+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a97d-5b50f05e844e", "parentComponentId": null }, { "bbox": { "h": 0.02, "w": 0.5, "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts; https://www.accessdata.fda.gov/cdrh_docs/pdf20/P200031B.pdf", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:24.83+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "1c33bae5-6b84-474b-aa0e-bf157a3b7d0d", "parentComponentId": null }, { "bbox": { "h": 0.03, "w": 0.5, "x": 0.07, "y": 0.59 }, "kind": "source-note", "text": "FDA PMA Approval Order Statement, Summary of Safety and Effectiveness Data – Sept 28, 2021", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:24.83+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "3c5149a3-f0f9-4c25-b8f0-b133c3b4bdb2", "parentComponentId": null }, { "bbox": { "h": 0.03, "w": 0.3, "x": 0.07, "y": 0.64 }, "kind": "title", "text": "II. INDICATIONS FOR USE", "attrs": null, "canon": { "kind": { "name": "Title", "slug": "title", "status": "active", "canonId": "019de52c-f7dd-76d9-b848-b1f12bd85cf4", "version": 1, "description": "Slide title or headline." }, "tool": null, "subkind": { "name": "Headline", "slug": "headline", "status": "active", "canonId": "019de52c-fae1-7463-9a7c-d60668eced0d", "version": 1, "description": null }, "framework": null }, "subkind": "headline", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:24.83+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "c8734160-ee7b-4f7c-82ad-c2f9dbff5861", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [ { "matchId": "b9211217-296c-4c4a-a821-4d32e6d52dd3", "evidence": "The slide explicitly claims a 'racket' and 'defrauded' payors, contrasting this with official FDA documentation.", "framework": null, "confidence": 0.95, "extraction": { "at": "2026-05-02 20:12:24.83+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 155, "frameworkName": "fraud-exposure" } ], "arcBeats": [], "loops": [], "locked": true }, { "page": 156, "type": "tension", "title": "The slide uses a combination of qualitative expert interview summaries and quantitative data from the company's own investor presentation to frame the company's", "function": "expose_contradiction", "rawType": "expose_contradiction", "block": null, "metadata": { "slideType": "expose_contradiction", "slideTypeCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-124c-75aa-984a-0a3d0d8fc8df", "version": 1, "description": null }, "function": "expose_contradiction", "functionCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-171f-776f-887c-73edaff4cf9c", "version": 1, "description": null }, "density": "overcrowded", "densityScore": 77, "componentCount": 9, "textChars": 1656, "nDataPoints": 4, "notes": "The slide uses a combination of qualitative expert interview summaries and quantitative data from the company's own investor presentation to frame the company's clinical claims as a 'ruse'.", "elementsJson": [ "paragraph", "bar_chart_grouped", "infographic", "screenshot" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:12:32.434+00", "seconds": 11.246, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/156", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-156", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "Moreover, even high-volume users told us the “clinical benefit” is just a charade so they can get away with using it for scheduling and convenience.", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:10+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a97c-bb6d9f1bfca5", "parentComponentId": null }, { "bbox": { "h": 0.3, "w": 0.43, "x": 0.07, "y": 0.6 }, "kind": "chart", "text": "~50% Reduction in Night-Time Transplants", "attrs": null, "canon": { "kind": { "name": "Chart", "slug": "chart", "status": "active", "canonId": "019de52c-f9a0-76ef-adc6-0b859109d1f8", "version": 1, "description": "Quantitative chart." }, "tool": null, "subkind": { "name": "Stacked bar chart", "slug": "bar-stacked", "status": "active", "canonId": "019de52c-feec-74bf-9028-15b74f84f0a7", "version": 1, "description": null }, "framework": null }, "subkind": "bar-stacked", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:32.434+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "72c59b47-6d7f-4bf8-9f97-7a85eec148ca", "parentComponentId": null }, { "bbox": { "h": 0.32, "w": 0.41, "x": 0.52, "y": 0.58 }, "kind": "diagram", "text": "Overall Impact of NOP Model in the U.S.", "attrs": null, "canon": { "kind": { "name": "Diagram", "slug": "diagram", "status": "active", "canonId": "019de52c-f9f0-734a-81de-15382ff28c65", "version": 1, "description": "Schematic or relational diagram." }, "tool": null, "subkind": null, "framework": null }, "subkind": "other", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:32.434+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "98c76b5c-36fc-4d84-8123-971eb6b49fe0", "parentComponentId": null }, { "bbox": null, "kind": "metric", "text": "Night-Time Transplants: 50%", "attrs": null, "canon": { "kind": { "name": "Metric", "slug": "metric", "status": "active", "canonId": "019de52c-f923-73bf-8081-d0b1a8c5264d", "version": 1, "description": "Big-number or KPI value." }, "tool": { "name": "Quantification", "slug": "quantification", "status": "active", "bestFor": null, "canonId": "019dd9e1-47ab-72ce-a079-aab1f5299e88", "version": 1, "bodyDocId": null, "description": "Translating a claim into numbers, charts, or tables.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": "primary", "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:10+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a97c-c2f855e74e75", "parentComponentId": null }, { "bbox": { "h": 0.45, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "paragraph", "text": "TransMedics entire premise is that its pump and aircraft enable organ transport for longer duration and farther distances than on ice, thus improving their viability and use. No one disputes that a liver with both a donor and recipient in Salt Lake City is perfectly fine on ice and does not require a $90,000 device and retrieval staff flown in on three separate jets - a real example from a Utah surgeon. TransMedics may claim that putting an organ on pump still enables assessment of biomarkers and viability, but the claim is specious: every single surgeon we interviewed admitted they have never seen an NOP retrieval surgeon decline an organ, as we shall detail – naturally, given the obvious incentive to sling every organ possible onto the device no matter how defective and move it via its private jets. Moreover, even high-volume users told us the “clinical benefit” is just a charade so they can get away with using it for scheduling and convenience. The ruse is visible in the company’s investor presentation:", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:32.434+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "e2880303-31e2-46e0-b90f-1c45363039e4", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "“clinical benefit” — High-volume users", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:10+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a97c-bd873ae679c2", "parentComponentId": null }, { "bbox": { "h": 0.03, "w": 0.4, "x": 0.07, "y": 0.9 }, "kind": "source-note", "text": "Source: TransMedics' OCS Liver Perfusion (OLP) Registry & Scientific Registry of Transplant Recipients (SRTR) Presented at the 2024 ASTS & ILTS Annual Meetings", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:32.434+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "0a195409-15f2-4fd0-826a-2e0d2126b2b3", "parentComponentId": null }, { "bbox": { "h": 0.02, "w": 0.7, "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts; https://investors.transmedics.com/static-files/5ed8fa71-5a64-4043-b1d4-025252b36ea1", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:32.434+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "24866639-ddcd-425b-a137-e27ba6c982c4", "parentComponentId": null }, { "bbox": { "h": 0.02, "w": 0.3, "x": 0.07, "y": 0.55 }, "kind": "title", "text": "TransMedics investor presentation, Oct 2024", "attrs": null, "canon": { "kind": { "name": "Title", "slug": "title", "status": "active", "canonId": "019de52c-f7dd-76d9-b848-b1f12bd85cf4", "version": 1, "description": "Slide title or headline." }, "tool": null, "subkind": { "name": "Subtitle", "slug": "subtitle", "status": "active", "canonId": "019de52c-fb09-739d-900c-815b0d9ac526", "version": 1, "description": null }, "framework": null }, "subkind": "subtitle", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:32.434+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "2a3718ce-5b36-49e9-b62f-066146bd0024", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [], "arcBeats": [], "loops": [], "locked": true }, { "page": 157, "type": "tension", "title": "The slide uses a testimonial to undermine the corporate narrative of 'Game Changer' technology, suggesting it is instead a tool for labor convenience.", "function": "expose_contradiction", "rawType": "expose_contradiction", "block": null, "metadata": { "slideType": "expose_contradiction", "slideTypeCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-124c-75aa-984a-0a3d0d8fc8df", "version": 1, "description": null }, "function": "expose_contradiction", "functionCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-171f-776f-887c-73edaff4cf9c", "version": 1, "description": null }, "density": "balanced", "densityScore": 47, "componentCount": 6, "textChars": 1142, "nDataPoints": 8, "notes": "The slide uses a testimonial to undermine the corporate narrative of 'Game Changer' technology, suggesting it is instead a tool for labor convenience.", "elementsJson": [ "paragraph", "quote_block", "bar_chart_grouped", "footnote" ], "confidence": 0.95, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:12:24.463+00", "seconds": 2.716, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/157", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-157", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "The recent investor day presentation in Dec was overt in talking up the shift to “Day-Time Liver Transplant” as a “Game Changer.”", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-23 01:18:10+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-70f3-714d-84c0-28ae59f78e83", "parentComponentId": null }, { "bbox": { "h": 0.18, "w": 0.25, "x": 0.13, "y": 0.76 }, "kind": "chart", "text": "OCS vs Non-OCS usage trends 2021-2024", "attrs": null, "canon": { "kind": { "name": "Chart", "slug": "chart", "status": "active", "canonId": "019de52c-f9a0-76ef-adc6-0b859109d1f8", "version": 1, "description": "Quantitative chart." }, "tool": null, "subkind": { "name": "Grouped bar chart", "slug": "bar-grouped", "status": "active", "canonId": "019de52c-ff3b-751e-a8ff-f21ff11097b1", "version": 1, "description": null }, "framework": null }, "subkind": "bar-grouped", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:24.463+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "a4adfdb0-fda7-4c27-8566-93ee47fe0268", "parentComponentId": null }, { "bbox": { "h": 0.15, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "paragraph", "text": "A senior ex-TransMedics employee spilled the beans, telling us what appears to be well-known among employees and surgeons – that the “the whole purpose of why the device was built and why it exists...to offer the flexibility”", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:24.463+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "378fb91b-6713-4fa3-8a06-635a33982f0f", "parentComponentId": null }, { "bbox": { "h": 0.22, "w": 0.86, "x": 0.07, "y": 0.44 }, "kind": "quote", "text": "The beauty of the technology is saying there is no rush...it can sit there as long as you need it to. You don't have to rush... they will just park it in the corner and wait until the doctor wakes up and is rested", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:24.463+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "5907dabf-ae95-40a4-8636-729a9f637f19", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "“The beauty of the technology is saying there is no rush...it can sit there as long as you need it to. You don't have to rush... when the liver arrives, they will sit on that - they will just park it in the corner and wait until the doctor wakes up and is rested... our clinical specialists are gone up to 40 hours long because there's no rush for procurement.” — Senior ex-employee at TransMedics", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-23 01:18:10+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-70f3-714d-84c0-2edae99c3678", "parentComponentId": null }, { "bbox": { "h": 0.03, "w": 0.68, "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts; https://investors.transmedics.com/static-files/ae80ac5c-1729-44f6-9c45-4cbb1ff14d7f", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:24.463+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "7471a17f-a6ff-4886-8ccd-63221fb6e222", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [ { "matchId": "619f2ecc-af26-457d-a1fa-a162f5278288", "evidence": "Contrasts investor day 'Game Changer' claim with ex-employee testimonial about scheduling convenience.", "framework": null, "confidence": 0.9, "extraction": { "at": "2026-05-02 20:12:24.463+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 157, "frameworkName": "ceo-quote-contradiction" } ], "arcBeats": [], "loops": [], "locked": true }, { "page": 158, "type": "tension", "title": "The slide uses a testimonial/interview format to challenge the necessity of the OCS device for local transplants.", "function": "expose_contradiction", "rawType": "expose_contradiction", "block": null, "metadata": { "slideType": "expose_contradiction", "slideTypeCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-124c-75aa-984a-0a3d0d8fc8df", "version": 1, "description": null }, "function": "expose_contradiction", "functionCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-171f-776f-887c-73edaff4cf9c", "version": 1, "description": null }, "density": "dense", "densityScore": 66, "componentCount": 7, "textChars": 2736, "nDataPoints": 1, "notes": "The slide uses a testimonial/interview format to challenge the necessity of the OCS device for local transplants.", "elementsJson": [ "paragraph", "callout_box", "footnote" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:12:26.671+00", "seconds": 4.797, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/158", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-158", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": { "h": 0.03, "w": 0.45, "x": 0.07, "y": 0.62 }, "kind": "callout", "text": "Substantial percentage of device usage is local and intra-city", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": null, "subkind": { "name": "Primary callout", "slug": "primary", "status": "active", "canonId": "019de52c-fbd1-70eb-a9ce-8997f8674c1d", "version": 1, "description": null }, "framework": null }, "subkind": "primary", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:26.671+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "cfe187cf-2925-4184-8128-cf1deb2f37d8", "parentComponentId": null }, { "bbox": { "h": 0.35, "w": 0.86, "x": 0.07, "y": 0.22 }, "kind": "paragraph", "text": "Leaving an organ on a $90,000 pump for 30 hours and mandating the use of private long-haul aircraft is therefore preposterous and unnecessary – unless you’re a surgeon abusing payors to avoid going to an OR at 2AM. We spoke withan ex-logistics employee at TransMedics, who revealed the audacious nature of the scheme and indicated that half the utilization of the device – as well as of the NOP service – is not only within driving distance, but that a large percentage is where both the donor and recipient are intra-city: “we get a huge volume of share from...within the city, like Boston to Boston, New York to New York...why would they use it when it costs a lot...you’re figuring out your logistics...we’ve had cases where the OCS device was used and our service was used within the same hospital...within a three-hour radius, about 50% of the cases.”", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:26.671+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "27d416df-d8b2-4a9e-9560-d2e8b265ca91", "parentComponentId": null }, { "bbox": { "h": 0.15, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "paragraph", "text": "Leaving aside that neither TransMedics surgeons nor transplant centers ever seem to reject an organ irrespective of whatever “data” the pump spits out, the majority of transplants that the device and NOP service are utilized for appear to be ones where both the donor and recipient are nearby – within driving distance.", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:26.671+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "ac71f73c-5a65-416e-8a91-bfff8e37ca5e", "parentComponentId": null }, { "bbox": { "h": 0.12, "w": 0.86, "x": 0.07, "y": 0.65 }, "kind": "quote", "text": "A: “We get a huge volume of share from local - within the city, like Boston to Boston, New York to New York type of transplant on our device. And you would ask why would they use it when it costs a lot of money. It costs a lot of money...you keep it there for whatever, a few hours while you’re figuring out your logistics between hospital A and hospital B. We’ve had cases where the OCS device was used, and our service was used within the same hospital. So, they take out the organ, they put it on the OCS device, and a couple of hours later.”", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:26.671+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "6fb713ad-af41-4dca-bc36-b586c1cfa296", "parentComponentId": null }, { "bbox": { "h": 0.08, "w": 0.86, "x": 0.07, "y": 0.78 }, "kind": "quote", "text": "Q: “What percentage of transplants are really close, like within a hospital? Within the city, an hour or two?”\nA: “Within a three-hour radius, about 50% of the cases, the donors and recipient are within a three-hour driving range. Roughly 50% within a three-hour driving range.” - Ex-logistics employee at Transmedics", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:26.671+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "77089ea8-488e-47e9-a8d3-21b6c823c888", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "“We get a huge volume of share from local - within the city, like Boston to Boston, New York to New York type of transplant on our device. And you would ask why would they use it when it costs a lot of money. It costs a lot of money...you keep it there for whatever, a few hours while you’re figuring out your logistics between hospital A and hospital B. We’ve had cases where the OCS device was used, and our service was used within the same hospital. So, they take out the organ, they put it on the OCS device, and a couple of hours later.” — Ex-logistics employee at Transmedics", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:11+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a97d-d9a9861e8c23", "parentComponentId": null }, { "bbox": { "h": 0.02, "w": 0.25, "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:26.671+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "23905d0a-5c67-4144-9cf7-631ac6935807", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [], "arcBeats": [], "loops": [], "locked": true }, { "page": 159, "type": "tension", "title": "The slide uses Q&A transcripts to undermine a business model premise.", "function": "expose_contradiction", "rawType": "expose_contradiction", "block": null, "metadata": { "slideType": "expose_contradiction", "slideTypeCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-124c-75aa-984a-0a3d0d8fc8df", "version": 1, "description": null }, "function": "expose_contradiction", "functionCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-171f-776f-887c-73edaff4cf9c", "version": 1, "description": null }, "density": "balanced", "densityScore": 45, "componentCount": 5, "textChars": 1429, "nDataPoints": 4, "notes": "The slide uses Q&A transcripts to undermine a business model premise.", "elementsJson": [ "paragraph", "quote_block" ], "confidence": 0.95, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:12:46.732+00", "seconds": 24.794, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/159", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-159", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "One transplant center after another emphasized that the vast majority of liver transplants in the US are within the same OPO region and within driving distance, given how the organ allocation algorithm works.", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:11+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a97d-c273dd69460b", "parentComponentId": null }, { "bbox": { "h": 0.55, "w": 0.86, "x": 0.07, "y": 0.35 }, "kind": "list", "text": "Most device usage is allegedly local... Vanderbilt: 90% of livers are locally retrieved... Massachusetts General: 80-85% procured within driving distance", "attrs": null, "canon": { "kind": { "name": "List", "slug": "list", "status": "active", "canonId": "019de52c-f94b-779b-a53b-fd4904a5f4d2", "version": 1, "description": "Bullet or numbered list." }, "tool": null, "subkind": { "name": "Bullet list", "slug": "bullet", "status": "active", "canonId": "019de52c-fc98-7169-a083-5cab805076ca", "version": 1, "description": null }, "framework": null }, "subkind": "bullet", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:46.732+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "cbd7122c-63ab-4768-8cec-6d9a79ed8a81", "parentComponentId": null }, { "bbox": { "h": 0.25, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "paragraph", "text": "A former OCS specialist also stated that most usage of the device is local and/or within the same city: “mostly locally, so Seattle to Seattle, Spokane to Seattle...50% of the time we were staying within Seattle.” One transplant center after another emphasized that the vast majority of liver transplants in the US are within the same OPO region and within driving distance, given how the organ allocation algorithm works, and bluntly rejected the notion that livers – the vast majority of TransMedics business – are traveling from California to Ohio, for example. Vanderbilt, one of the highest volume centers in the world, stated 90% of livers are procured locally – “most of the DCD’s are recovered by their own OPO...DCD livers don’t travel very far.” Massachusetts General told us 80-85%.", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:46.732+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "49b1737b-a49e-45ad-9d12-108b5fa03c60", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "Most of the DCD's are recovered by their own OPO...DCD livers don't travel very far. Now there is some problem that they are traveling more because of TransMedics. — Transplant surgeon in a leadership role at Vanderbilt", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:11+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a97d-c74e69fbd5db", "parentComponentId": null }, { "bbox": { "h": 0.02, "w": 0.25, "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:46.732+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "1bf11fa7-b138-4e83-951f-493100954357", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [ { "matchId": "3a701efa-83ff-48eb-8979-5021aa9a235b", "evidence": "The slide uses expert testimony to contradict the company's business model claims.", "framework": null, "confidence": 0.9, "extraction": { "at": "2026-05-02 20:12:46.732+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 159, "frameworkName": "fraud-exposure" } ], "arcBeats": [], "loops": [], "locked": true }, { "page": 160, "type": "tension", "title": "The slide uses direct quotes from transplant directors to challenge the value proposition of TransMedics' NOP service.", "function": "expose_contradiction", "rawType": "expose_contradiction", "block": null, "metadata": { "slideType": "expose_contradiction", "slideTypeCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-124c-75aa-984a-0a3d0d8fc8df", "version": 1, "description": null }, "function": "expose_contradiction", "functionCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-171f-776f-887c-73edaff4cf9c", "version": 1, "description": null }, "density": "balanced", "densityScore": 39, "componentCount": 6, "textChars": 890, "nDataPoints": 2, "notes": "The slide uses direct quotes from transplant directors to challenge the value proposition of TransMedics' NOP service.", "elementsJson": [ "paragraph", "quote_block" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:12:28.647+00", "seconds": 6.305, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/160", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-160", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "it's not like we have a slew of organs in California, Oregon, Hawaii that are getting transplanted here, for sure", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:11+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a97d-ad3b89e7cb37", "parentComponentId": null }, { "bbox": { "h": 0.45, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "paragraph", "text": "A transplant program director in the Midwest derided the notion that livers travel far for transplant. One of TransMedics highest-volume users implied that most of his device and NOP utilization is hence unnecessary and off-label...", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:28.647+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "b11d6966-96a4-475e-961d-f01b727525e8", "parentComponentId": null }, { "bbox": { "h": 0.15, "w": 0.86, "x": 0.07, "y": 0.52 }, "kind": "quote", "text": "High volume user says 75-80% of livers are local", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:28.647+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "61566278-0da2-44a4-8e03-8cbbe07ee5c3", "parentComponentId": null }, { "bbox": { "h": 0.25, "w": 0.86, "x": 0.07, "y": 0.68 }, "kind": "quote", "text": "Organ allocation algorithm means most livers procured within driving distance", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:28.647+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "eaf07387-ec00-4a06-8f4b-65e0af4d1e2b", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "“it's not like we have a slew of organs in California, Oregon, Hawaii that are getting transplanted here, for sure” — Transplant hepatologist and director of a Midwest academic center. “for practical purposes, it's pretty unusual I would get an organ from that far away.” — Transplant surgeon and transplant program director at a leading Northeast academic center.", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:11+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a97d-b37d79dc6cbc", "parentComponentId": null }, { "bbox": { "h": 0.03, "w": 0.3, "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:28.647+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "46b8467e-eb35-457b-b5da-c8aa704f6a36", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [], "arcBeats": [], "loops": [], "locked": true }, { "page": 161, "type": "tension", "title": "The slide uses a Q&A format to substantiate the claim of reckless off-label usage.", "function": "name_villain", "rawType": "villain_critique", "block": null, "metadata": { "slideType": "villain_critique", "slideTypeCanon": { "name": "Villain critique", "slug": "villain_critique", "status": "active", "canonId": "019de52d-10bc-7136-bf20-09de59d17447", "version": 1, "description": null }, "function": "name_villain", "functionCanon": { "name": "Name villain", "slug": "name_villain", "status": "active", "canonId": "019de52d-1746-70d6-bc58-5eeaf5865526", "version": 1, "description": null }, "density": "balanced", "densityScore": 46, "componentCount": 5, "textChars": 2064, "nDataPoints": 0, "notes": "The slide uses a Q&A format to substantiate the claim of reckless off-label usage.", "elementsJson": [ "paragraph", "quote_block", "footnote" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:12:25.543+00", "seconds": 2.841, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/161", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-161", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "TransMedics is therefore, we believe, extremely reckless, as the off-label use occurs by its own device technicians, known as OCS Specialists – who hospitals must use.", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:11+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a97d-eda39018cc7d", "parentComponentId": null }, { "bbox": { "h": 0.45, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "paragraph", "text": "An executive at one of the largest OPO’s stated that “I’ve never seen a device manufacturer so boldly engage in off-label use themselves” - “It’s their technician...they don’t permit anyone to operate the device...you have to go through their national program...they are the ones operating it.” While physicians have latitude to use devices off-label, it is illegal for medical device companies to market or promote their devices for off-label use. TransMedics is therefore, we believe, extremely reckless, as the off-label use occurs by its own device technicians, known as OCS Specialists – who hospitals must use. Moreover, ex-employees stated that the company’s case coordinators direct the NOP retrieval surgeons and clinically decide that an organ is acceptable and to place it on the pump, suggesting that they jump the gun in the case of expedited offers before a center has even accepted the organ, thereby implicating TransMedics directly in off-label usage – where the rubber meets the road in terms of legal jeopardy.", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:25.543+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "ed27f4ae-17af-4279-96b9-ea070920f1a6", "parentComponentId": null }, { "bbox": { "h": 0.25, "w": 0.86, "x": 0.07, "y": 0.55 }, "kind": "quote", "text": "TransMedics allegedly engages “in off-label use themselves”\nQ: “The problem is if a company promotes off-label usage, have you heard TransMedics promote the convenience of the pediatric usage?\nI mean, to some extent, by definition, they’re promoting it because they’re the ones using it, their technician, their surgeon.”\nA: “That’s exactly right. It’s their technician. They don’t permit anyone to operate the machine. You have to go through their national program. They are the ones operating it. They’re the ones doing it. I’ve never seen a device manufacturer so boldly engage in off-label use themselves.” – Executive at a West Coast OPO, longtime industry veteran", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:25.543+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "82a0380e-f13c-49fd-8e88-3f2931df8c94", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "“I’ve never seen a device manufacturer so boldly engage in off-label use themselves” - Executive at a West Coast OPO, longtime industry veteran", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:11+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a97d-f36841b320bb", "parentComponentId": null }, { "bbox": { "h": 0.02, "w": 0.3, "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:25.543+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "c018e28b-c338-480a-a5a0-c4ced394e97a", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [], "arcBeats": [], "loops": [], "locked": true }, { "page": 162, "type": "tension", "title": "The slide uses a Q&A format to present expert testimony regarding potential misuse of medical devices.", "function": "expose_contradiction", "rawType": "expose_contradiction", "block": null, "metadata": { "slideType": "expose_contradiction", "slideTypeCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-124c-75aa-984a-0a3d0d8fc8df", "version": 1, "description": null }, "function": "expose_contradiction", "functionCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-171f-776f-887c-73edaff4cf9c", "version": 1, "description": null }, "density": "overcrowded", "densityScore": 85, "componentCount": 9, "textChars": 3935, "nDataPoints": 2, "notes": "The slide uses a Q&A format to present expert testimony regarding potential misuse of medical devices.", "elementsJson": [ "paragraph", "quote_block" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:12:27.377+00", "seconds": 4.551, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/162", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-162", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "Surgeons freely admit that the only use case is convenience, to which the executive replied “100%...they told me first-hand...I’ll sleep overnight...TransMedics can go and get it...but TransMedics won’t let you just hire their surgeon to go...not something they will permit...you’ve got to use the cartridge...”", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:11+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a97e-308e87428d14", "parentComponentId": null }, { "bbox": { "h": 0.04, "w": 0.86, "x": 0.07, "y": 0.45 }, "kind": "list", "text": "Highest-volume users allegedly “do crazy things” like using device when donor and recipient are in the same hospital", "attrs": null, "canon": { "kind": { "name": "List", "slug": "list", "status": "active", "canonId": "019de52c-f94b-779b-a53b-fd4904a5f4d2", "version": 1, "description": "Bullet or numbered list." }, "tool": null, "subkind": { "name": "Bullet list", "slug": "bullet", "status": "active", "canonId": "019de52c-fc98-7169-a083-5cab805076ca", "version": 1, "description": null }, "framework": null }, "subkind": "bullet", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:27.377+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "21d682a7-3c81-44e6-80cc-2bebd088ae91", "parentComponentId": null }, { "bbox": { "h": 0.04, "w": 0.86, "x": 0.07, "y": 0.7 }, "kind": "list", "text": "Surgeons admit the use case is convenience, but can’t only use TMDX surgeon – have to pay for device", "attrs": null, "canon": { "kind": { "name": "List", "slug": "list", "status": "active", "canonId": "019de52c-f94b-779b-a53b-fd4904a5f4d2", "version": 1, "description": "Bullet or numbered list." }, "tool": null, "subkind": { "name": "Bullet list", "slug": "bullet", "status": "active", "canonId": "019de52c-fc98-7169-a083-5cab805076ca", "version": 1, "description": null }, "framework": null }, "subkind": "bullet", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:27.377+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "654da4ed-7a5a-4a0e-a2c4-fff83044828c", "parentComponentId": null }, { "bbox": { "h": 0.25, "w": 0.86, "x": 0.07, "y": 0.19 }, "kind": "paragraph", "text": "“I’ve heard they do crazy things...sometimes the organ donor will be in the hospital and the liver is going to a patient next door and they’ll still put it on that machine...that’s just crazy...there’s no clinical benefit to that liver going on that machine to go from one room to another.” We noted that surgeons freely admit that the only use case is convenience, to which the executive replied “100%...they told me first-hand...I’ll sleep overnight...TransMedics can go and get it...but TransMedics won’t let you just hire their surgeon to go...not something they will permit...you’ve got to use the cartridge...”", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:27.377+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "268dfa74-9e0b-47e5-a928-31ce2d3b64fd", "parentComponentId": null }, { "bbox": { "h": 0.2, "w": 0.86, "x": 0.07, "y": 0.49 }, "kind": "paragraph", "text": "Q: “There’s a very insular circle of Egyptians at the top: the CEO, Tamer, Magdy, Waleed’s sister, runs the lung business. It seems to be a similar Egyptian circle among their highest-volume users, this guy at Houston Methodist, Mark Ghobrial is Egyptian. There’s a guy at Henry Ford in Michigan; one of their highest-volume users is Lebanese. So, I noticed a lot of their highest-volume implanters share some similarity in background. I’ve heard Houston Methodist is using 170 of their devices. That could be $20-30 million of revenue to this company once you add in all the airfare and all that stuff. One guy.”\nA: “I’ve heard they do crazy things, too. That’s a big hospital. Sometimes, the organ donor will be in the hospital, and the liver is going to a patient next door, and they’ll still put it on that machine. That’s just crazy. There’s no clinical benefit to that liver going on that machine to go from one room to another.” – Executive at a West Coast OPO, longtime industry veteran", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:27.377+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "35447a97-c4d1-4882-8b56-82210878a19c", "parentComponentId": null }, { "bbox": { "h": 0.22, "w": 0.86, "x": 0.07, "y": 0.74 }, "kind": "paragraph", "text": "Q: “I’m hearing that most usage is off-label - it doesn’t actually need to be used because the organs are perfectly fine; there’s no issue with cold storage. Some surgeons that have been candid - they’re using it for convenience because they don’t want to get up at 2 am.”\nA: “Oh, 100%. I’ve got that first-hand. They told me first-hand. I’ve been operating all day. I can’t travel to Reno to go do a donor. If TransMedics is available, I’ll take it. I’ll sleep overnight. TransMedics can go and get it. But TransMedics won’t let you just hire their surgeon to go and get it and bring it back. That is not something that they will permit. You’ve got to use the cartridge.”\nQ: “One West Coast center, they have one OR, even though they’re a high-volume center, so they want to stack the cases, so they just stick them on the machine. If Medicare or the few private payors that cover this that are paying $100,000-200,000 to help with the logistics and scheduling, I mean, they would hit the roof. Nobody’s paying six figures so you can do it when it’s convenient for you.”\nA: “You’re 100% spot on.” – Executive at a West Coast OPO, longtime industry veteran", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:27.377+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "4dd7e28f-1915-4e0f-9d3a-b66253898f89", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "“There’s a very insular circle of Egyptians at the top: the CEO, Tamer, Magdy, Waleed’s sister, runs the lung business. It seems to be a similar Egyptian circle among their highest-volume users, this guy at Houston Methodist, Mark Ghobrial is Egyptian.” — Executive at a West Coast OPO, longtime industry veteran", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:11+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a97e-3769f7d9777b", "parentComponentId": null }, { "bbox": { "h": 0.02, "w": 0.5, "x": 0.07, "y": 0.96 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts; https://www.accessdata.fda.gov/cdrh_docs/pdf20/P200031B.pdf", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:27.377+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "2a34e29a-a4a6-45a2-ad88-2a466b97c1b0", "parentComponentId": null }, { "bbox": { "h": 0.12, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "title", "text": "The same OPO executive – one of the highest-volume in the country as far as organs placed – expressed shock at the off-label practices, using Houston Methodist as example, who we think is a top 2 or 3 “super user”", "attrs": null, "canon": { "kind": { "name": "Title", "slug": "title", "status": "active", "canonId": "019de52c-f7dd-76d9-b848-b1f12bd85cf4", "version": 1, "description": "Slide title or headline." }, "tool": null, "subkind": { "name": "Headline", "slug": "headline", "status": "active", "canonId": "019de52c-fae1-7463-9a7c-d60668eced0d", "version": 1, "description": null }, "framework": null }, "subkind": "headline", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:27.377+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "d883f275-16c7-4c6e-893f-4ed6b0d9ca26", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [], "arcBeats": [], "loops": [], "locked": true }, { "page": 163, "type": "tension", "title": "The slide uses direct quotes to expose a misalignment between the stated value proposition (reduced hospitalization) and the actual usage (scheduling convenienc", "function": "expose_contradiction", "rawType": "expose_contradiction", "block": null, "metadata": { "slideType": "expose_contradiction", "slideTypeCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-124c-75aa-984a-0a3d0d8fc8df", "version": 1, "description": null }, "function": "expose_contradiction", "functionCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-171f-776f-887c-73edaff4cf9c", "version": 1, "description": null }, "density": "overcrowded", "densityScore": 79, "componentCount": 9, "textChars": 3422, "nDataPoints": 0, "notes": "The slide uses direct quotes to expose a misalignment between the stated value proposition (reduced hospitalization) and the actual usage (scheduling convenience).", "elementsJson": [ "paragraph", "callout_box" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:12:32.442+00", "seconds": 9.598, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/163", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-163", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": { "h": 0.03, "w": 0.86, "x": 0.07, "y": 0.71 }, "kind": "callout", "text": "Only benefit is “scheduling convenience”; surgeons misleading hospitals into “perceiving” reduced hospitalization", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": null, "subkind": { "name": "Primary callout", "slug": "primary", "status": "active", "canonId": "019de52c-fbd1-70eb-a9ce-8997f8674c1d", "version": 1, "description": null }, "framework": null }, "subkind": "primary", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:32.442+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "a5fee188-e18f-46d7-808b-1a186f1bbf9a", "parentComponentId": null }, { "bbox": { "h": 0.03, "w": 0.86, "x": 0.07, "y": 0.51 }, "kind": "callout", "text": "Surgeons are “real blunt” in admitting the usage is only for scheduling convenience", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": null, "subkind": { "name": "Primary callout", "slug": "primary", "status": "active", "canonId": "019de52c-fbd1-70eb-a9ce-8997f8674c1d", "version": 1, "description": null }, "framework": null }, "subkind": "primary", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:32.442+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "f64d9674-f856-419a-9c49-cb80c67eabfb", "parentComponentId": null }, { "bbox": null, "kind": "callout", "text": "the main and perhaps only value proposition was scheduling convenience.", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:11+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a97e-1df4c9fe4288", "parentComponentId": null }, { "bbox": { "h": 0.25, "w": 0.86, "x": 0.07, "y": 0.22 }, "kind": "paragraph", "text": "One of TransMedics highest-volume users implied that surgeons are manipulating administrators with purported benefits: “I will freely admit that most surgeons are using mostly subjective criteria” and that they wrongly attribute any “perceived” benefit to the device” – “the biggest cheerleader for this is a busy surgeon who doesn’t want to come in at 2AM…of course, when you go say [reduced hospitalization] to the hospital system, they love that…the main and perhaps only value proposition was scheduling convenience.” A second surgeon, who leads a major transplant program in Pennsylvania, was crystal clear: “delaying cases for the morning is true…let me real blunt…when we do this, it’s for the operating room team to start at the normal time at 7:30 in the morning…do some centers use it on everyone when they don’t need to? Absolutely correct and absolute fact.”", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:32.442+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "28d59069-4cfb-4e43-b69c-9300dd303700", "parentComponentId": null }, { "bbox": { "h": 0.18, "w": 0.86, "x": 0.07, "y": 0.75 }, "kind": "paragraph", "text": "Q: “What really is the value proposition? If 75% to 80% of livers are still within the region, is it really a benefit from spending $100,000 versus doing it the traditional way with cold storage?” A: “So, now you can pump a liver, a liver that historically you would not use based on - I will freely admit most surgeons are using mostly subjective criteria for what is a good organ or not….and so, they attribute mostly right, but somewhat wrongly subjectively the benefit from all this to the device. The biggest cheerleader for this is a busy surgeon who doesn’t want to come in at 2AM, would rather come at 8 in the morning and do a transplant, perceives that utilization of these devices reduces the hospitalization - of course, when you go say that to the hospital system, they love that…the main and perhaps only value proposition was scheduling convenience.” - Transplant hepatologist and director of the liver program at a Midwest academic center; one of", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:32.442+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "e61db2a3-4a7c-4659-bcb1-6879ff39dfe9", "parentComponentId": null }, { "bbox": { "h": 0.12, "w": 0.86, "x": 0.07, "y": 0.55 }, "kind": "quote", "text": "“Delaying cases for the morning is true - let me be real blunt. You have to beg the nurses to come in and pay them a lot of money and anesthesia, the same way. In fact, some of the anesthesia people will quit after a while because they don’t want to work all night. So, when we do this, it’s for the operating room team to start at the normal time, at 7:30 in the morning…So, do some centers use it on everyone when they don’t need to? Absolutely correct and absolute fact.” - Transplant surgeon and transplant program director at a major academic center in Pennsylvania", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:32.442+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "f3dcdae8-b129-45e9-9586-d21e385a43f7", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "“Delaying cases for the morning is true - let me be real blunt. You have to beg the nurses to come in and pay them a lot of money and anesthesia, the same way. In fact, some of the anesthesia people will quit after a while because they don't want to work all night. So, when we do this, it's for the operating room team to start at the normal time, at 7:30 in the morning...So, do some centers use it on everyone when they don't need to? Absolutely correct and absolute fact.” — Transplant surgeon and transplant program director at a major academic center in Pennsylvania", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:11+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a97e-218c76ce767c", "parentComponentId": null }, { "bbox": { "h": 0.02, "w": 0.3, "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:32.442+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "e4553989-783e-44c3-b714-f6a4a481b1d3", "parentComponentId": null }, { "bbox": { "h": 0.15, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "title", "text": "We have never heard surgeons – or any physicians – so openly confess that their usage is for non-clinical, off-label reasons.", "attrs": null, "canon": { "kind": { "name": "Title", "slug": "title", "status": "active", "canonId": "019de52c-f7dd-76d9-b848-b1f12bd85cf4", "version": 1, "description": "Slide title or headline." }, "tool": null, "subkind": { "name": "Headline", "slug": "headline", "status": "active", "canonId": "019de52c-fae1-7463-9a7c-d60668eced0d", "version": 1, "description": null }, "framework": null }, "subkind": "headline", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:32.442+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "cdba026c-7d34-4ee9-867d-4bebe5562094", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [ { "matchId": "7e5d7336-00e8-4acc-82b6-6878c5f507b8", "evidence": "The slide explicitly exposes a gap between the stated clinical value and the actual usage for convenience, framing it as a deceptive practice.", "framework": null, "confidence": 0.9, "extraction": { "at": "2026-05-02 20:12:32.442+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 163, "frameworkName": "fraud-exposure" } ], "arcBeats": [], "loops": [], "locked": true }, { "page": 164, "type": "tension", "title": "The slide uses a primary headline followed by a detailed supporting quote, highlighting the ethical and financial concerns regarding off-label use of perfusion ", "function": "expose_contradiction", "rawType": "quote_slide", "block": null, "metadata": { "slideType": "quote_slide", "slideTypeCanon": { "name": "Quote slide", "slug": "quote_slide", "status": "active", "canonId": "019de52d-098e-7555-a9fd-4f0af7e80bc2", "version": 1, "description": null }, "function": "expose_contradiction", "functionCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-171f-776f-887c-73edaff4cf9c", "version": 1, "description": null }, "density": "balanced", "densityScore": 48, "componentCount": 5, "textChars": 2683, "nDataPoints": 0, "notes": "The slide uses a primary headline followed by a detailed supporting quote, highlighting the ethical and financial concerns regarding off-label use of perfusion technology.", "elementsJson": [ "paragraph", "quote_block", "footnote" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:12:26.309+00", "seconds": 3.282, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/164", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-164", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "The off-label usage is simply unsustainable – centers are on to the game that surgeons are playing and cracking down on usage.", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:11+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a97e-06f78c788219", "parentComponentId": null }, { "bbox": { "h": 0.45, "w": 0.86, "x": 0.07, "y": 0.37 }, "kind": "quote", "text": "“Outrageous organ acquisition charges” simply for surgeon convenience; surgeons fabricating clinical excuses as a cover “The convenience of pumping...is even more bizarre that they would take on such a cost just for convenience...the organ procurement area, I mean, legality - you would think that there would be some overseeing body that says you have to charge x amount or you have to cover x percent. You can’t have outrageous organ acquisition charges to make up for your organ procurement poor performance or for the surgeon’s convenience. But there just isn’t. You could say you need to pump. You wanted to see how it does. You could always say that. I mean, sure, I don’t know if they will put that in the chart, but they’ll pump. They can pump anything and say, look, I was wondering about the functionality of the lungs, and I need to check it out for a couple of hours. And these surgeons want their convenience, so they would say that in a heartbeat and not blink. It’s hard to prove that the surgeon didn’t want to see the liver function improve or, lung O2 improve, or heart function improve, and that it was really around OR convenience. I doubt anybody would say that out loud....they wouldn’t put in a patient’s chart that they’re pumping something to free up an OR.” – Longtime executive at major OPO (organ procurement organization), and on UNOS committees", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Pull quote", "slug": "pull-quote", "status": "active", "canonId": "019de52c-fbf9-76fe-97e1-a0b7540445c9", "version": 1, "description": null }, "framework": null }, "subkind": "pull-quote", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:26.309+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "51eb493c-f0c1-4c6b-9989-29279169f0b8", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "“bizarre that they would take on such a cost for convenience...you can’t have outrageous organ acquisition charges...for the surgeon’s convenience.” He doubted the legality of surgeon’s simply fabricating a clinical indication – “they can pump anything and say, look, I was wondering about the functionality of the lung, and I need to check it for a couple of hours...I don’t think anybody would say that out loud.” — Longtime executive at major OPO (organ procurement organization), and on UNOS committees", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:11+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a97e-0ad59f5086d3", "parentComponentId": null }, { "bbox": { "h": 0.02, "w": 0.25, "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:26.309+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "dade5d46-0d7b-4cb1-aa6d-9f2135dda5e2", "parentComponentId": null }, { "bbox": { "h": 0.25, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "title", "text": "The off-label usage is simply unsustainable – centers are on to the game that surgeons are playing and cracking down on usage. An influential, longtime OPO executive who serves on UNOS committees called it “bizarre that they would take on such a cost for convenience...you can’t have outrageous organ acquisition charges...for the surgeon’s convenience.” He doubted the legality of surgeon’s simply fabricating a clinical indication – “they can pump anything and say, look, I was wondering about the functionality of the lung, and I need to check it for a couple of hours...I don’t think anybody would say that out loud.”", "attrs": null, "canon": { "kind": { "name": "Title", "slug": "title", "status": "active", "canonId": "019de52c-f7dd-76d9-b848-b1f12bd85cf4", "version": 1, "description": "Slide title or headline." }, "tool": null, "subkind": { "name": "Headline", "slug": "headline", "status": "active", "canonId": "019de52c-fae1-7463-9a7c-d60668eced0d", "version": 1, "description": null }, "framework": null }, "subkind": "headline", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:26.309+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "b2e78edc-f84a-4599-b8d1-2d8080ef0263", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [ { "matchId": "51fb5bfb-b05a-436a-8037-b59360cc2e9e", "evidence": "The slide explicitly frames the behavior as 'fabricating a clinical indication' and 'unsustainable' cost-shifting.", "framework": null, "confidence": 0.9, "extraction": { "at": "2026-05-02 20:12:26.309+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 164, "frameworkName": "fraud-exposure" } ], "arcBeats": [], "loops": [], "locked": true }, { "page": 165, "type": "tension", "title": "The slide uses a Q&A format to present a negative testimonial/critique of the company's sales tactics.", "function": "name_villain", "rawType": "villain_critique", "block": null, "metadata": { "slideType": "villain_critique", "slideTypeCanon": { "name": "Villain critique", "slug": "villain_critique", "status": "active", "canonId": "019de52d-10bc-7136-bf20-09de59d17447", "version": 1, "description": null }, "function": "name_villain", "functionCanon": { "name": "Name villain", "slug": "name_villain", "status": "active", "canonId": "019de52d-1746-70d6-bc58-5eeaf5865526", "version": 1, "description": null }, "density": "dense", "densityScore": 54, "componentCount": 6, "textChars": 2751, "nDataPoints": 0, "notes": "The slide uses a Q&A format to present a negative testimonial/critique of the company's sales tactics.", "elementsJson": [ "paragraph", "quote_block", "footnote" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:12:26.583+00", "seconds": 3.414, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/165", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-165", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "I think it’s going to the surgeon and then using the surgeon to bully the administration; “we’re going to do this.”", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:12+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a97e-7515f0e48c8c", "parentComponentId": null }, { "bbox": { "h": 0.45, "w": 0.86, "x": 0.07, "y": 0.35 }, "kind": "paragraph", "text": "“Preying” on surgeons who then “bully” administrators and “hide behind excuses” to use device for convenience\nA: “If I’m TransMedics, I’m hitting up the surgeons because they’re going to surgery in the middle of the night. These poor surgeons are stuck, like okay, do I either continue to not sleep like I have in the last decade? Or do I have this solution where I can have somewhat of a lifestyle. It sounds to me like he’s probably preying on the transplant surgeons. That’s what I think. I don’t think it’s the administration. I think it’s going to the surgeon and then using the surgeon to bully the administration; “we’re going to do this.”\nQ: “And to use their device?”\nA: “Yeah, and to use their device and they hide behind the excuse that, “Well, it’s going to improve the outcomes, and we’re going to be able to do more of it, and we’re going to have less turnover, etc., etc., etc. In my experience, the administrators, they don’t know what’s going on half the time. So, I think they’re probably getting bullied by the surgeons.” -CEO of a major OPO (Organ Procurement Organization), longtime industry executive", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:26.583+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "b17b4dcc-ff95-4576-9c5e-b5faa495f2a7", "parentComponentId": null }, { "bbox": { "h": 0.12, "w": 0.86, "x": 0.07, "y": 0.22 }, "kind": "quote", "text": "“he’s probably preying on the transplant surgeons...I think it’s going to the surgeon and then using the surgeon to bully the administration...they hide behind the excuse that ‘well it’s going to improve the outcomes’...the administrators, they don’t know what going on half the time...they’re probably getting bullied by the surgeons.”", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Pull quote", "slug": "pull-quote", "status": "active", "canonId": "019de52c-fbf9-76fe-97e1-a0b7540445c9", "version": 1, "description": null }, "framework": null }, "subkind": "pull-quote", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:26.583+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "403cc441-7c12-4a63-b220-4f100a6e7795", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "“If I’m TransMedics, I’m hitting up the surgeons because they’re going to surgery in the middle of the night. These poor surgeons are stuck, like okay, do I either continue to not sleep like I have in the last decade? Or do I have this solution where I can have somewhat of a lifestyle. It sounds to me like he’s probably preying on the transplant surgeons. That’s what I think. I don’t think it’s the administration. I think it’s going to the surgeon and then using the surgeon to bully the administration; “we’re going to do this.” ... “Well, it’s going to improve the outcomes, and we’re going to be able to do more of it, and we’re going to have less turnover, etc., etc., etc. In my experience, the administrators, they don’t know what’s going on half the time. So, I think they’re probably getting bullied by the surgeons.” — CEO of a major OPO (Organ Procurement Organization), longtime industry executive", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:12+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a97e-7baf5f9a14c7", "parentComponentId": null }, { "bbox": { "h": 0.02, "w": 0.25, "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:26.583+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "6a0d62fd-b5e4-45db-a1ea-326fd1557b1a", "parentComponentId": null }, { "bbox": { "h": 0.15, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "title", "text": "The head of a major OPO stated that TransMedics is “preying” on surgeons seeking to improve their personal lifestyles, who then concoct clinical excuses to manipulate and “bully” naive transplant administrators", "attrs": null, "canon": { "kind": { "name": "Title", "slug": "title", "status": "active", "canonId": "019de52c-f7dd-76d9-b848-b1f12bd85cf4", "version": 1, "description": "Slide title or headline." }, "tool": null, "subkind": { "name": "Headline", "slug": "headline", "status": "active", "canonId": "019de52c-fae1-7463-9a7c-d60668eced0d", "version": 1, "description": null }, "framework": null }, "subkind": "headline", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:26.583+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "6f839645-b763-4bda-a7c2-f0112eb01d88", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [], "arcBeats": [], "loops": [], "locked": true }, { "page": 166, "type": "tension", "title": "The slide uses direct quotes from UCSF hospital administrators to frame the argument that TransMedics usage is being curtailed due to cost and lack of clinical ", "function": "expose_contradiction", "rawType": "expose_contradiction", "block": null, "metadata": { "slideType": "expose_contradiction", "slideTypeCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-124c-75aa-984a-0a3d0d8fc8df", "version": 1, "description": null }, "function": "expose_contradiction", "functionCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-171f-776f-887c-73edaff4cf9c", "version": 1, "description": null }, "density": "dense", "densityScore": 55, "componentCount": 6, "textChars": 2984, "nDataPoints": 0, "notes": "The slide uses direct quotes from UCSF hospital administrators to frame the argument that TransMedics usage is being curtailed due to cost and lack of clinical indication.", "elementsJson": [ "paragraph", "quote_block", "footnote" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:12:28.02+00", "seconds": 4.791, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/166", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-166", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": { "h": 0.18, "w": 0.86, "x": 0.07, "y": 0.52 }, "kind": "callout", "text": "Surgeons using device when it “wasn’t clinically indicated”; administrators have cracked down\n“Our heart transplant group was using it because they might not have a procurement surgeon available to go get a heart, and this could just be a standard heart. It's not like anything that required the device but they would use it out of convenience, which is a very expensive backup plan. We've since remedied that...we were using it even when it wasn’t clinically indicated. For lung transplant, our surgical director is very mindful of cost. [Redacted] will only use it when absolutely necessary.” – UCSF hospital administrator", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": null, "subkind": { "name": "Primary callout", "slug": "primary", "status": "active", "canonId": "019de52c-fbd1-70eb-a9ce-8997f8674c1d", "version": 1, "description": null }, "framework": null }, "subkind": "primary", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:28.02+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "ab901209-0ef7-4f57-9e33-baf4ba428182", "parentComponentId": null }, { "bbox": { "h": 0.18, "w": 0.86, "x": 0.07, "y": 0.72 }, "kind": "callout", "text": "“Using it too liberally” as “surgeons are preferring it” because it’s “more convenient”\nQ: “Why did the surgical director and/or you make the decision to try to move away from TransMedics? Is it primarily cost or is it you don't see much clinical benefit from it?”\nA: “I think the surgeon, Dr. [redacted]. questioned if we’re using it too liberally, like on organs we would have taken otherwise before TransMedics was even available to us, but now the surgeons are preferring it because it might be more convenient. If you have this option at your fingertips...they’re making that call and they’re enjoying it. I think he thinks it’s being used a little bit too liberally, and the cost has been a concern.” - UCSF hospital administrator", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": null, "subkind": { "name": "Primary callout", "slug": "primary", "status": "active", "canonId": "019de52c-fbd1-70eb-a9ce-8997f8674c1d", "version": 1, "description": null }, "framework": null }, "subkind": "primary", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:28.02+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "b170b39e-8272-4e64-9afd-1d42e4eb7df0", "parentComponentId": null }, { "bbox": null, "kind": "callout", "text": "UCSF, a high-volume user who told us they intend to shut down most TransMedics usage in early 2025, clued into the game its surgeons were playing across all three programs - heart, lung, and liver.", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:11+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a97e-46ab2c562757", "parentComponentId": null }, { "bbox": { "h": 0.45, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "paragraph", "text": "However, hospitals and transplant administrators are increasingly realizing that surgeons are disingenuous when they say they need “to see liver function improve, lung O2 to improve, or heart function to improve” – and are beginning to severely limit or eliminate TransMedics usage entirely, as we shall cover in more detail. UCSF, a high-volume user who told us they intend to shut down most TransMedics usage in early 2025, clued into the game its surgeons were playing across all three programs - heart, lung, and liver: “its not like anything that required the device but they would use it out of convenience, which is a very expensive backup plan...even when it wasn’t clinically indicated”; “we’ve since remedied that.” The “surgical director is very mindful of coast...and questioned if we’re using it too liberally, like on organs we would have taken otherwise before TransMedics was available...the cost has been a concern.”", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:28.02+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "df6ede99-c74b-4ae6-81c5-e1212ad22147", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "“its not like anything that required the device but they would use it out of convenience, which is a very expensive backup plan...even when it wasn’t clinically indicated”; “we’ve since remedied that.” The “surgical director is very mindful of cost...and questioned if we’re using it too liberally, like on organs we would have taken otherwise before TransMedics was available...the cost has been a concern.” — UCSF hospital administrator", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:11+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a97e-48fefbe13b34", "parentComponentId": null }, { "bbox": { "h": 0.02, "w": 0.25, "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:28.02+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "64345775-7e66-4b2d-9f40-a9618efa228a", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [], "arcBeats": [], "loops": [], "locked": true }, { "page": 167, "type": "tension", "title": "Uses direct quotes from surgeons at Utah and UCSD to support the thesis of off-label, convenience-driven usage.", "function": "expose_contradiction", "rawType": "testimonial", "block": null, "metadata": { "slideType": "testimonial", "slideTypeCanon": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52d-0a2d-7782-8a48-7e84df92cc97", "version": 1, "description": null }, "function": "expose_contradiction", "functionCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-171f-776f-887c-73edaff4cf9c", "version": 1, "description": null }, "density": "dense", "densityScore": 63, "componentCount": 7, "textChars": 2815, "nDataPoints": 0, "notes": "Uses direct quotes from surgeons at Utah and UCSD to support the thesis of off-label, convenience-driven usage.", "elementsJson": [ "paragraph", "callout_box", "quote_block", "footnote" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:12:30.597+00", "seconds": 7.338, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/167", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-167", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "A Utah surgeon described the device as sort of a drug for surgeons’ lifestyles: “you don’t have to work all night...daytime is wonderful...it’s so much easier for me...the bitching and moaning from the OR is so much better.”", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:12+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a97e-d2b76f507cde", "parentComponentId": null }, { "bbox": { "h": 0.22, "w": 0.86, "x": 0.07, "y": 0.22 }, "kind": "paragraph", "text": "UCSD and Utah told us so directly. A Utah surgeon described the device as sort of a drug for surgeons’ lifestyles: “you don’t have to work all night...daytime is wonderful...it’s so much easier for me...the bitching and moaning from the OR is so much better.” A UCSD surgeon echoed the bliss of scheduling transplants when you want them, even if it extends the time an organ is outside of a body: “it’s the genie out of the bottle once you get a taste...transplant surgeons make our money from 11 at night to 5 in the morning...but it’s not fun...I can do it in the morning.”", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:30.597+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "a3642604-fa0c-42b7-bab1-8f4f6854ac6e", "parentComponentId": null }, { "bbox": { "h": 0.15, "w": 0.86, "x": 0.07, "y": 0.65 }, "kind": "quote", "text": "UCSD states primary reason is convenience and lifestyle... “...it’s the genie out of the bottle once you get a taste - transplant surgeons, we make our money from 11 at night to 5 in the morning. But it’s not like it—flying all over the country and being up all night is exhausting, especially when you get into your 50’s. Doing a case that is scheduled and is going to go well, I can do it in the morning, it’s hard to put a price tag on that. It really changes the dynamics of transplant.”", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:30.597+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "2daf1012-9afd-40c6-b090-9abb28d5caed", "parentComponentId": null }, { "bbox": { "h": 0.15, "w": 0.86, "x": 0.07, "y": 0.48 }, "kind": "quote", "text": "High volume Utah surgeon admits device usage is for convenience... “Yes, the liver just shows up at your door at 7 am, and you don’t have to work all night... this paradigm shift of someone else doing the donor and us doing the transplant during the daytime is wonderful. It’s so much easier for me. The bitching and moaning from the OR is so much better.”", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:30.597+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "e7f74b99-7076-4e1f-9cd2-a3c6547aa91e", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "“Yes, the liver just shows up at your door at 7 am, and you don’t have to work all night... this paradigm shift of someone else doing the donor and us doing the transplant during the daytime is wonderful. It’s so much easier for me. The bitching and moaning from the OR is so much better.” — Transplant surgeon at a high volume academic center in Utah; “...it’s the genie out of the bottle once you get a taste - transplant surgeons, we make our money from 11 at night to 5 in the morning. But it’s not fun. We don’t like it—flying all over the country and being up all night is exhausting, especially when you get into your 50’s. Doing a case that is scheduled and is going to go well, I can do it in the morning, it’s hard to put a price tag on that. It really changes the dynamics of transplant.” — Transplant surgeon", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:12+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a97e-d68c4eff6ab5", "parentComponentId": null }, { "bbox": { "h": 0.02, "w": 0.25, "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:30.597+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "96b02406-22ed-4de3-9714-34d8600458ca", "parentComponentId": null }, { "bbox": { "h": 0.15, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "title", "text": "Our research interviews lead us to believe that TransMedics highest-volume users – such as Houston Methodist, Mayo Arizona, Henry Ford, UC San Diego, University of Utah, and others – are particularly notorious for off-label usage and that most of their utilization is not for clinical reasons.", "attrs": null, "canon": { "kind": { "name": "Title", "slug": "title", "status": "active", "canonId": "019de52c-f7dd-76d9-b848-b1f12bd85cf4", "version": 1, "description": "Slide title or headline." }, "tool": null, "subkind": { "name": "Headline", "slug": "headline", "status": "active", "canonId": "019de52c-fae1-7463-9a7c-d60668eced0d", "version": 1, "description": null }, "framework": null }, "subkind": "headline", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:30.597+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "125dc42d-5c90-451e-8659-8f9017193fca", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [], "arcBeats": [], "loops": [], "locked": true }, { "page": 168, "type": "tension", "title": "The slide uses direct quotes to highlight a discrepancy between the purported clinical value of the device and the actual operational use case.", "function": "expose_contradiction", "rawType": "expose_contradiction", "block": null, "metadata": { "slideType": "expose_contradiction", "slideTypeCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-124c-75aa-984a-0a3d0d8fc8df", "version": 1, "description": null }, "function": "expose_contradiction", "functionCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-171f-776f-887c-73edaff4cf9c", "version": 1, "description": null }, "density": "dense", "densityScore": 54, "componentCount": 6, "textChars": 1883, "nDataPoints": 2, "notes": "The slide uses direct quotes to highlight a discrepancy between the purported clinical value of the device and the actual operational use case.", "elementsJson": [ "paragraph", "quote_block", "footnote" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:12:26.356+00", "seconds": 3.089, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/168", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-168", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "The surgeon flatly stated that the main rationale is stacking and scheduling transplants as they only have one operating room – “we’ve had three livers on OCS at the same time”; “you can do that case at your leisure and you can stack cases”; “even take a break for dinner in between.”", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:12+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a97e-8f099a88e749", "parentComponentId": null }, { "bbox": { "h": 0.15, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "paragraph", "text": "Surgeons have become creative in finding excuses to jam payors for $100,000 to $400,000 per TransMedics case, even coming up with self-serving studies that purport to show that errors are higher if they have to operate at night.", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:26.356+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "ce5d9144-f6d4-4e05-b7d7-bbed78584daf", "parentComponentId": null }, { "bbox": { "h": 0.15, "w": 0.86, "x": 0.07, "y": 0.52 }, "kind": "quote", "text": "What has become more and more normal... you can do that case at your leisure and you can stack cases... you can just kind of do them one after the other... and you can just take a break for dinner in between.", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:26.356+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "47145d72-f6c3-4c02-a890-adf5f35d2fd2", "parentComponentId": null }, { "bbox": { "h": 0.12, "w": 0.86, "x": 0.07, "y": 0.78 }, "kind": "quote", "text": "We just can use a lot of organs that we were afraid to use before; whether TransMedics makes all the difference or whether it just gives us courage is another good question.", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:26.356+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "85cbefb6-db69-4f30-a50d-680cf2575af9", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "“What has become more and more normal, and even more dramatic than what I predicted - once surgeons and teams and anesthesiologists get a taste of a liver that is placed on machine perfusion and you can do that case at your leisure and you can stack cases - we’ve had situations where we’ve had three livers on OCS at the same time and you can just kind of do them one after the other after the other and even take a break for dinner in between, that has really changed the way we approach it. Whether it’s consciously or subconsciously, you can find a reason to put it on the machine so that you don’t have to do it in the middle of the night...I would say the biggest thing is that you can schedule cases when you want them, and if you have a busy program, it’s easier for everybody if you can do that case when you want to do it. And that has become an increasing indication for putting a liver on the device.” — Transplant surgeon", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:12+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a97e-92eed37ad3b5", "parentComponentId": null }, { "bbox": { "h": 0.03, "w": 0.3, "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:26.356+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "7eda0222-06b2-4705-bcc7-f57e6a223a54", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [ { "matchId": "2952e1d9-9e12-47a3-ac94-c3d95e3103a0", "evidence": "The slide explicitly frames the surgeon's behavior as 'finding excuses to jam payors' for high fees.", "framework": null, "confidence": 0.9, "extraction": { "at": "2026-05-02 20:12:26.356+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 168, "frameworkName": "fraud-exposure" } ], "arcBeats": [], "loops": [], "locked": true }, { "page": 169, "type": "tension", "title": "The slide uses direct quotes from anonymous experts to build a case of 'expensive abuse' of medical technology.", "function": "expose_contradiction", "rawType": "expose_contradiction", "block": null, "metadata": { "slideType": "expose_contradiction", "slideTypeCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-124c-75aa-984a-0a3d0d8fc8df", "version": 1, "description": null }, "function": "expose_contradiction", "functionCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-171f-776f-887c-73edaff4cf9c", "version": 1, "description": null }, "density": "dense", "densityScore": 56, "componentCount": 6, "textChars": 4057, "nDataPoints": 0, "notes": "The slide uses direct quotes from anonymous experts to build a case of 'expensive abuse' of medical technology.", "elementsJson": [ "paragraph", "callout_box", "footnote" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:12:27.3+00", "seconds": 3.901, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/169", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-169", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "Highest volume users have doubled transplant volumes through \"very expensive abuse\" with no improvement in outcomes", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:11+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a97e-5fb9ae6639b9", "parentComponentId": null }, { "bbox": { "h": 0.45, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "paragraph", "text": "Mayo Arizona and Houston Methodist came up repeatedly in our interviews, with surgeons alleging that they use dubious practices to spike their TransMedics device usage. We quoted an OPO executive who alleged that Methodist uses the pump even when the donor and recipient are in the same hospital. UCSF shared similar conduct at Mayo, where both retrieval and transplant were at their center but “the surgeon decided to put that organ on TransMedics because they were doing another case” – “when I shared that with one of our surgeons, he was like oh, I could see how that would be cool.” A leading liver transplant surgeon, perhaps the most influential in the world, described what he stated were conversations with Ghobrial at Methodist, which suggested off-label usage as driving their growth and TransMedics usage: “Ghobrial has definitely grown his program, more than doubled its size...the guy in Mayo Clinic in Scottsdale has more than doubled theirs...this is potential abuse of technology...a very expensive abuse...you’re really doing a disservice because you’re increasing the cost without incremental increase in outcomes.”", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:27.3+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "09c5daaf-523a-461a-921e-d317962a134e", "parentComponentId": null }, { "bbox": { "h": 0.18, "w": 0.86, "x": 0.07, "y": 0.55 }, "kind": "quote", "text": "Mayo Arizona allegedly using device when donor and recipient are both in the same hospital. “I heard that there was a donor at Mayo in the hospital where the transplant program is. And the surgeon decided to put that organ on TransMedics because they were doing another case. So, that kind of convenience. It’s not like it was coming from a far distance or anything clinically was required for this donor. But it was a convenience thing. When I shared that with one of our surgeons, he was like oh, I could see how that would be cool.” - Executive at a pre-eminent West Coast academic transplant center, one of the highest volume in the world", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:27.3+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "149fa66f-62c0-48ac-a8c5-ee3b36a0acb9", "parentComponentId": null }, { "bbox": { "h": 0.18, "w": 0.86, "x": 0.07, "y": 0.76 }, "kind": "quote", "text": "Highest volume users have doubled transplant volumes through “very expensive abuse” with no improvement in outcomes. “Mark Ghobrial has definitely grown his program, more than doubled its size. The guy in Mayo Clinic at Scottsdale has more than doubled theirs. Part of it is that they’re willing to take organs that others haven’t been willing to - older donors, all that stuff.... I remember Congress jumping up and down about the Cost Report because they were saying it’s being abused. Well, this is potential abuse of technology, a very expensive abuse...if you took it to the extreme and talk about an $8 billion industry, you’re really doing a disservice because you’re increasing the cost without incremental increase in outcomes.” - One of the top liver transplant surgeons in the world, based at a leading Midwest academic center", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:27.3+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "7fb78f36-78ca-4090-baf9-4a9c85189112", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "\"I heard that there was a donor at Mayo in the hospital where the transplant program is. And the surgeon decided to put that organ on TransMedics because they were doing another case. So, that kind of convenience. It's not like it was coming from a far distance or anything clinically was required for this donor. But it was a convenience thing. When I shared that with one of our surgeons, he was like oh, I could see how that would be cool.\" — Executive at a pre-eminent West Coast academic transplant center, one of the highest volume in the world; \"Mark Ghobrial has definitely grown his program, more than doubled its size...The guy in Mayo Clinic at Scottsdale has more than doubled theirs...Part of it is that they're willing to take organs that others haven't been willing to - older donors, all that stuff....I remember Congress jumping up and down about the Cost Report because they were saying it's being abused. Well, this is potential abuse of technology, a very expensive abuse...if you took it to the extreme and talk about an $8 billion industry, you're really doing a disservice because you're increasing the cost without incremental increase in outcomes.\" — One of the top liver transplant surgeons in the world, based at a leading Midwest academic center", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:11+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a97e-606b4af33bc9", "parentComponentId": null }, { "bbox": { "h": 0.02, "w": 0.25, "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:27.3+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "e7563ccb-234d-4f00-b9d4-de40cb5a53d8", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [], "arcBeats": [], "loops": [], "locked": true }, { "page": 170, "type": "tension", "title": "The slide uses a Q&A transcript format to build a case against the clinical justification of the product's usage.", "function": "expose_contradiction", "rawType": "expose_contradiction", "block": null, "metadata": { "slideType": "expose_contradiction", "slideTypeCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-124c-75aa-984a-0a3d0d8fc8df", "version": 1, "description": null }, "function": "expose_contradiction", "functionCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-171f-776f-887c-73edaff4cf9c", "version": 1, "description": null }, "density": "dense", "densityScore": 56, "componentCount": 5, "textChars": 3636, "nDataPoints": 4, "notes": "The slide uses a Q&A transcript format to build a case against the clinical justification of the product's usage.", "elementsJson": [ "paragraph", "quote_block", "footnote" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 21:25:50.949+00", "seconds": 4.382, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/170", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-170", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "Methodist is using TransMedics to \"basically make transplants a semi-elective operation\"; \"I frankly find that unjustifiable.\"", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:12+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a97e-e83467f0a44c", "parentComponentId": null }, { "bbox": { "h": 0.55, "w": 0.86, "x": 0.07, "y": 0.35 }, "kind": "list", "text": "Methodist and Mayo use of TransMedics is for convenience and “really unjustified”\nQ: “So, you're saying most of the use now is livers where it doesn't need to be used?”\nA: “I know this because I talked to Mark Ghobrial about this. Seventy percent of their transplants use TransMedics. And when I asked him, I asked these are all DCD's? And he goes, no. He goes, in their program, only about 30% to 40% are DCD or older donors, so the rest of them are being used to basically make transplants a semi-elective operation. In other words, instead of operating at midnight or 1 or 2 in the morning operating all night long, they're using these devices to push the operation off until the morning. To me, that's a really unjustified use of resources to make the operation more convenient. It is really unjustified to use this technology to make life more convenient for the transplant team because I didn't train that way; I don't.”\nQ: “I've heard from calls that the main use case is that people don't want to operate at night. For the transplant center, it's just logistically easier to push it to the next day. They're leaving these livers on these pumps now for 10, 15, 20 hours, 30 hours sometimes.”\nA: “I agree with that. For me, I frankly find that unjustifiable. I can see once in a while, you've got a transplant scheduled, and then they call you up, and you have a great organ for another patient, but you only have one operating room.”\nQ: “If Ghobrial said 70% of their liver transplants use TransMedics, and for most of them, it's just because they pump it overnight because it's more convenient?”\nA: “Yes, that's what it sounds like to me. This is what our discussion was. They're doing it to make the operation semi-elective.”\nQ: “How many cases is Ghobrial doing as a high-volume user?”\nA: “I think they're doing 200 transplants a year. That's a lot. That's like 125, 150 - you do the math, but 70% of those use cases are for convenience.”\nQ: “Single-handedly alone, he's probably driving $15 million in revenue for the company.”\nA: “Oh yeah, possibly. Look at who the big users are. The same thing with Mayo. Mayo went from 100 transplants and they're doing 200-plus a year also.” –One of the top liver transplant surgeons in the world, based at a leading Midwest academic center", "attrs": null, "canon": { "kind": { "name": "List", "slug": "list", "status": "active", "canonId": "019de52c-f94b-779b-a53b-fd4904a5f4d2", "version": 1, "description": "Bullet or numbered list." }, "tool": null, "subkind": { "name": "Bullet list", "slug": "bullet", "status": "active", "canonId": "019de52c-fc98-7169-a083-5cab805076ca", "version": 1, "description": null }, "framework": null }, "subkind": "bullet", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:25:50.949+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "23972368-295d-415f-a48d-403e0703425a", "parentComponentId": null }, { "bbox": { "h": 0.25, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "paragraph", "text": "The information that Ghobrial at Houston Methodist allegedly shared with this surgeon is troubling – that ~70% of their TransMedics cases are simply “to push the operation off until the morning...it is really unjustified to use this...to make life more convenient for the transplant team.” We highlight that the surgeon who relayed this color is perhaps the world’s top liver transplant KOL, who stated that Methodist is using TransMedics to “basically make transplants a semi-elective operation”; “I frankly find that unjustifiable.” He estimated that Methodist and Mayo Arizona are using ~400 TransMedics pumps – a significant percentage of the company’s revenue particularly when NOP transport charges are included.", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:25:50.949+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "84488d2b-db18-4b2d-9c81-afdc128b1472", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "“I know this because I talked to Mark Ghobrial about this. Seventy percent of their transplants use TransMedics. And when I asked him, I asked are these all DCD's? And he goes, no. He goes, in their program, only about 30% to 40% are DCD or older donors, so the rest of them are being used to basically make transplants a semi-elective operation.” — One of the top liver transplant surgeons in the world, based at a leading Midwest academic center", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:12+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a97e-ecc301aa34e9", "parentComponentId": null }, { "bbox": { "h": 0.03, "w": 0.3, "x": 0.07, "y": 0.93 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:25:50.949+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "8c63d5f2-0da6-4d98-85d8-2da40a4b13e7", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [], "arcBeats": [], "loops": [], "locked": true }, { "page": 171, "type": "tension", "title": "The slide uses expert quotes to frame 'back to base' usage as a potentially harmful, off-label practice driven by convenience rather than clinical necessity.", "function": "expose_contradiction", "rawType": "expose_contradiction", "block": null, "metadata": { "slideType": "expose_contradiction", "slideTypeCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-124c-75aa-984a-0a3d0d8fc8df", "version": 1, "description": null }, "function": "expose_contradiction", "functionCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-171f-776f-887c-73edaff4cf9c", "version": 1, "description": null }, "density": "dense", "densityScore": 62, "componentCount": 7, "textChars": 1875, "nDataPoints": 1, "notes": "The slide uses expert quotes to frame 'back to base' usage as a potentially harmful, off-label practice driven by convenience rather than clinical necessity.", "elementsJson": [ "paragraph", "quote_block", "footnote" ], "confidence": 0.95, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:12:26.941+00", "seconds": 3.061, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/171", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-171", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "Surgeons and OPO’s indicate that off-label misuse for convenience is now taking a more extreme turn, leading to injured and lost organs: “back to base” use where centers retrieve the organ in an ice cooler, and then put it on the pump back at the hospital for convenience and scheduling.", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:12+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a97f-30df0a6701a5", "parentComponentId": null }, { "bbox": { "h": 0.25, "w": 0.86, "x": 0.07, "y": 0.13 }, "kind": "paragraph", "text": "“back to base” use where centers retrieve the organ in an ice cooler, and then put it on the pump back at the hospital for convenience and scheduling. Such use is not indicated, approved, nor was it the protocol in the pivotal trial...", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:26.941+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "e3a5d811-cc6f-46fb-97cc-6e5ea83b22e9", "parentComponentId": null }, { "bbox": { "h": 0.15, "w": 0.86, "x": 0.07, "y": 0.45 }, "kind": "quote", "text": "“There are two different practices now for TransMedics... you procure the organ the old-fashioned way, put it into an ice bucket/chest. You transport it back to your institution, then you put the organ on the machine, and then you do the pumping at your own hospital.”", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Pull quote", "slug": "pull-quote", "status": "active", "canonId": "019de52c-fbf9-76fe-97e1-a0b7540445c9", "version": 1, "description": null }, "framework": null }, "subkind": "pull-quote", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:26.941+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "c980a93f-7622-43b6-b68a-5e01a238aad3", "parentComponentId": null }, { "bbox": { "h": 0.25, "w": 0.86, "x": 0.07, "y": 0.65 }, "kind": "quote", "text": "“Smaller programs using it for other reasons, logistics to delay the OR time until the morning... I would say that the ratio is probably 2:1: 2 procured the NOP way and 1 the back-to-base way...”", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Pull quote", "slug": "pull-quote", "status": "active", "canonId": "019de52c-fbf9-76fe-97e1-a0b7540445c9", "version": 1, "description": null }, "framework": null }, "subkind": "pull-quote", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:26.941+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "d98597ef-bc7c-4d0b-83c3-db4d7ed82b3f", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "“There are two different practices now for TransMedics. There's the one that they do, which they bring the machine to the donor hospital. They procure the organ. They put the organ on the machine at the donor hospital, and then they transport the whole device with the organ to your center. And then, there's a practice which is logistically easier, it's certainly a lot cheaper, which is you procure the organ the old-fashioned way, put it into an ice bucket/chest. You transport it back to your institution, then you put the organ on the machine, and then you do the pumping at your own hospital.” — One of the top liver transplant surgeons in the world, based at a leading Midwest academic center", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:12+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a97f-3783406fae52", "parentComponentId": null }, { "bbox": { "h": 0.03, "w": 0.3, "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:26.941+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "f2afad16-210d-46f5-8e60-aaebfc0f7fad", "parentComponentId": null }, { "bbox": { "h": 0.12, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "title", "text": "Surgeons and OPO’s indicate that off-label misuse for convenience is now taking a more extreme turn, leading to injured and lost organs", "attrs": null, "canon": { "kind": { "name": "Title", "slug": "title", "status": "active", "canonId": "019de52c-f7dd-76d9-b848-b1f12bd85cf4", "version": 1, "description": "Slide title or headline." }, "tool": null, "subkind": { "name": "Headline", "slug": "headline", "status": "active", "canonId": "019de52c-fae1-7463-9a7c-d60668eced0d", "version": 1, "description": null }, "framework": null }, "subkind": "headline", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:26.941+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "b3e40396-666e-453f-b343-89a5e8703300", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [ { "matchId": "323b2654-c31c-47ea-8c24-025374014ccf", "evidence": "The slide explicitly frames a practice as 'off-label misuse' and 'not indicated' to expose potential risks or regulatory issues.", "framework": null, "confidence": 0.85, "extraction": { "at": "2026-05-02 20:12:26.941+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 171, "frameworkName": "fraud-exposure" } ], "arcBeats": [], "loops": [], "locked": true }, { "page": 172, "type": "tension", "title": "The slide uses a Q&A format to highlight a specific industry pain point regarding the misuse of medical technology.", "function": "expose_contradiction", "rawType": "testimonial", "block": null, "metadata": { "slideType": "testimonial", "slideTypeCanon": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52d-0a2d-7782-8a48-7e84df92cc97", "version": 1, "description": null }, "function": "expose_contradiction", "functionCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-171f-776f-887c-73edaff4cf9c", "version": 1, "description": null }, "density": "dense", "densityScore": 67, "componentCount": 7, "textChars": 2913, "nDataPoints": 1, "notes": "The slide uses a Q&A format to highlight a specific industry pain point regarding the misuse of medical technology.", "elementsJson": [ "paragraph", "quote_block" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:12:27.921+00", "seconds": 3.699, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/172", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-172", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": { "h": 0.05, "w": 0.86, "x": 0.07, "y": 0.48 }, "kind": "callout", "text": "Centers increasingly using the device off-label for storage at the hospital after initial recovery/transport on ice", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": null, "subkind": { "name": "Primary callout", "slug": "primary", "status": "active", "canonId": "019de52c-fbd1-70eb-a9ce-8997f8674c1d", "version": 1, "description": null }, "framework": null }, "subkind": "primary", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:27.921+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "e5814b17-2375-4e26-bb63-d5d7fd88366a", "parentComponentId": null }, { "bbox": { "h": 0.25, "w": 0.86, "x": 0.07, "y": 0.22 }, "kind": "paragraph", "text": "He estimated that 10% of livers in his region are now lost to damage through this practice, whether via physiologic injury from ice to pump or because organs are left on the pump for excessive periods: “that could get TransMedics into some trouble”; “they’re under increased scrutiny by the federal government…we have some frustrations with them because transplant centers will use it off-label”; “we have a surgeon here locally [who] recovers the liver and sends it to transplant program…and then that program puts the liver on the pump…well, they transplanted the liver late…they actually lost the liver on the pump.”", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:27.921+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "b601cb0a-7c5b-43c7-bee3-e79b467aafe7", "parentComponentId": null }, { "bbox": { "h": 0.25, "w": 0.86, "x": 0.07, "y": 0.68 }, "kind": "quote", "text": "Q: “Explain that off-label dynamic to me.”\nA: “They should send the TransMedics recovery surgeon... and then they use the device. The benefit really of the pump is that it allows the surgeons to sleep and transplant during normal business hours... we have a surgeon here locally. He shows up and recovers the liver, and sends it to that transplant program. And then, that program puts the liver on the pump and then transplanted the liver later. Well, they transplanted the liver late. They actually lost the liver on the pump. What we’ve seen - it’s happened three times in the last few months is transplant centers don’t want to pay the excessive cost to use their logistics, so they’ll have the organ recovered locally and then sent to them. So, I think that could get TransMedics into some trouble... the behavior of some of the transplant programs because of the TransMedics cost.” – CEO of a major OPO (Organ Procurement Organization), longtime industry executive", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:27.921+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "2896a09d-4966-4f40-adb2-42f6d0b8ef56", "parentComponentId": null }, { "bbox": { "h": 0.15, "w": 0.86, "x": 0.07, "y": 0.53 }, "kind": "quote", "text": "A: “It’s an ultra-expensive device. They’re under increased scrutiny by the federal government. We have some frustrations with them because transplant centers will use it off-label, meaning they don’t want to pay for TransMedics for the recovery and the flight... we have a local recovery. We send them the liver, and then they put it on the TransMedics device. But they don’t want to pay for the recovery and the flight.”", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:27.921+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "460e78f0-ae1e-47c1-8c35-cbd5f460c7ec", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "“It’s an ultra-expensive device. They’re under increased scrutiny by the federal government. We have some frustrations with them because transplant centers will use it off-label... we have a surgeon here locally. He shows up and recovers the liver, and sends it to that transplant program. And then, that program puts the liver on the pump and then transplanted the liver later. Well, they transplanted the liver late. They actually lost the liver on the pump.” — CEO of a major OPO (Organ Procurement Organization), longtime industry executive", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:12+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a97e-a9d915364d41", "parentComponentId": null }, { "bbox": { "h": 0.02, "w": 0.3, "x": 0.07, "y": 0.96 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:27.921+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "38ca843a-013b-4c52-894b-e002d377b90b", "parentComponentId": null }, { "bbox": { "h": 0.15, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "title", "text": "The CEO of an influential OPO in the Midwest echoed that centers are increasingly transporting organs on ice and then storing them on the device at the hospital for scheduling convenience.", "attrs": null, "canon": { "kind": { "name": "Title", "slug": "title", "status": "active", "canonId": "019de52c-f7dd-76d9-b848-b1f12bd85cf4", "version": 1, "description": "Slide title or headline." }, "tool": null, "subkind": { "name": "Headline", "slug": "headline", "status": "active", "canonId": "019de52c-fae1-7463-9a7c-d60668eced0d", "version": 1, "description": null }, "framework": null }, "subkind": "headline", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:27.921+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "785beddd-dda5-40df-9241-8cffaff02c96", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [], "arcBeats": [], "loops": [], "locked": true }, { "page": 173, "type": "tension", "title": "The slide highlights a specific operational failure (delayed pump usage) causing a 10% loss rate in the region.", "function": "expose_contradiction", "rawType": "quote_slide", "block": null, "metadata": { "slideType": "quote_slide", "slideTypeCanon": { "name": "Quote slide", "slug": "quote_slide", "status": "active", "canonId": "019de52d-098e-7555-a9fd-4f0af7e80bc2", "version": 1, "description": null }, "function": "expose_contradiction", "functionCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-171f-776f-887c-73edaff4cf9c", "version": 1, "description": null }, "density": "balanced", "densityScore": 34, "componentCount": 5, "textChars": 936, "nDataPoints": 1, "notes": "The slide highlights a specific operational failure (delayed pump usage) causing a 10% loss rate in the region.", "elementsJson": [ "paragraph", "quote_block", "footnote" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:12:27.649+00", "seconds": 3.406, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/173", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-173", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "“Three different transplant centers” lost livers recently from off-label usage; 10% of livers in region damaged/lost to the practice", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:12+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a97f-7b9942dbcee2", "parentComponentId": null }, { "bbox": { "h": 0.45, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "paragraph", "text": "The CEO of the Midwest OPO stated that “it’s happened three times in the last few months” that livers were lost to damage when centers left them on the pump too long after bring them back to the hospital on ice.", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:27.649+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "a90cf5d5-4e52-4c2a-8462-b1d4e3db6f53", "parentComponentId": null }, { "bbox": { "h": 0.45, "w": 0.86, "x": 0.07, "y": 0.48 }, "kind": "quote", "text": "“Three different transplant centers” lost livers recently from off-label usage; 10% of livers in region damaged/lost to the practice...", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:27.649+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "0f5b6cbd-a2e8-4f0b-8f9b-78fbee355d31", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "“the liver is supposed to go on the pump in the operating room right after recovery...it’s not supposed to be shipped and then go on the pump four or five hours later...that’s been our experience lately...they’re like, we’re going to put it on and then...transplant in the morning and then the lactic acid is too high,” — CEO of a major OPO (Organ Procurement Organization), longtime industry executive", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:12+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a97f-7fc36415b033", "parentComponentId": null }, { "bbox": { "h": 0.03, "w": 0.25, "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:27.649+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "803d91ea-ca15-4a22-8b27-0e3d277eca42", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [], "arcBeats": [], "loops": [], "locked": true }, { "page": 174, "type": "tension", "title": "The slide contrasts the author's claims of widespread off-label use with the official FDA 'Indications for Use' text.", "function": "expose_contradiction", "rawType": "expose_contradiction", "block": null, "metadata": { "slideType": "expose_contradiction", "slideTypeCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-124c-75aa-984a-0a3d0d8fc8df", "version": 1, "description": null }, "function": "expose_contradiction", "functionCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-171f-776f-887c-73edaff4cf9c", "version": 1, "description": null }, "density": "dense", "densityScore": 67, "componentCount": 7, "textChars": 2642, "nDataPoints": 3, "notes": "The slide contrasts the author's claims of widespread off-label use with the official FDA 'Indications for Use' text.", "elementsJson": [ "paragraph", "screenshot" ], "confidence": 0.95, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:12:27.66+00", "seconds": 3.223, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/174", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-174", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "by our estimate, almost every organ placed on the device violates one or more of these criteria and is therefore off-label use.", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:12+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a97e-ba9100546bae", "parentComponentId": null }, { "bbox": { "h": 0.22, "w": 0.8, "x": 0.13, "y": 0.68 }, "kind": "paragraph", "text": "The TransMedics® Organ Care System (OCS™) Liver is a portable extracorporeal liver perfusion and monitoring system indicated for preservation and monitoring of hemodynamics and metabolic function which allows for ex vivo assessment of liver allografts from donors after brain death (DBD) or liver allografts from donors after circulatory death (DCD) ≤55 years old and with ≤30 mins of warm ischemic time, macrosteatosis ≤15%, in a near-physiologic, normothermic and functioning state intended for a potential transplant recipient.", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:27.66+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "c2bdc5a3-d3f8-4519-80cc-83ce5b134183", "parentComponentId": null }, { "bbox": { "h": 0.45, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "paragraph", "text": "Off-label misuse of TransMedics device is, we think, centered on two aspects. The first, utilization for surgeon lifestyle and convenience with no clinical indication or benefit, exploits hospitals and payors who incur six-figure sums per case so surgeons can work hours of their own choosing. The second type of misuse is just as prevalent but far more insidious: placing dubious, high-risk organs on the device in violation of specific criteria on the FDA label – by our estimate, almost every organ placed on the device violates one or more of these criteria and is therefore off-label use. We focus on the liver version of OCS as it is the core of the company’s revenue and growth, as the heart and lung pumps are basically a failure. Per the label, the device is only allowed for livers that meet 3 critical parameters of viability, plus a fourth not explicitly mentioned in the label but which was key in the pivotal trial and FDA approval: 1) the DCD donor is ≤55 years old; 2) ≤30 minutes of warm ischemic time; 3) ≤15% macrosteatosis; and 4) the time the liver is on the device. We explain the significance of each in turn.", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:27.66+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "d1f6f9ca-a529-4258-9dca-f3583903b6e3", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "The TransMedics® Organ Care System (OCS™) Liver is a portable extracorporeal liver perfusion and monitoring system indicated for preservation and monitoring of hemodynamics and metabolic function which allows for ex vivo assessment of liver allografts from donors after brain death (DBD) or liver allografts from donors after circulatory death (DCD) ≤55 years old and with ≤30 mins of warm ischemic time, macrosteatosis ≤15%, in a near-physiologic, normothermic and functioning state intended for a potential transplant recipient. — FDA PMA Approval Order Statement, Summary of Safety and Effectiveness Data – Sept 28, 2021", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:12+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a97e-be5eeaf2da0f", "parentComponentId": null }, { "bbox": { "h": 0.02, "w": 0.5, "x": 0.07, "y": 0.59 }, "kind": "source-note", "text": "FDA PMA Approval Order Statement, Summary of Safety and Effectiveness Data – Sept 28, 2021", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:27.66+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "022c0cb8-4a04-4485-8d0a-50c87f2614ee", "parentComponentId": null }, { "bbox": { "h": 0.02, "w": 0.55, "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts; https://www.accessdata.fda.gov/cdrh_docs/pdf20/P200031B.pdf", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:27.66+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "644b0520-3585-4cef-9175-ac76170e998e", "parentComponentId": null }, { "bbox": { "h": 0.03, "w": 0.3, "x": 0.07, "y": 0.63 }, "kind": "title", "text": "II. INDICATIONS FOR USE", "attrs": null, "canon": { "kind": { "name": "Title", "slug": "title", "status": "active", "canonId": "019de52c-f7dd-76d9-b848-b1f12bd85cf4", "version": 1, "description": "Slide title or headline." }, "tool": null, "subkind": { "name": "Headline", "slug": "headline", "status": "active", "canonId": "019de52c-fae1-7463-9a7c-d60668eced0d", "version": 1, "description": null }, "framework": null }, "subkind": "headline", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:27.66+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "7d9b1677-954b-4c05-bfb1-8065a73a6c64", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [], "arcBeats": [], "loops": [], "locked": true }, { "page": 175, "type": "tension", "title": "The slide uses a 'villain_critique' approach by quoting an ex-employee to expose what the author considers to be fraudulent medical claims.", "function": "expose_contradiction", "rawType": "villain_critique", "block": null, "metadata": { "slideType": "villain_critique", "slideTypeCanon": { "name": "Villain critique", "slug": "villain_critique", "status": "active", "canonId": "019de52d-10bc-7136-bf20-09de59d17447", "version": 1, "description": null }, "function": "expose_contradiction", "functionCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-171f-776f-887c-73edaff4cf9c", "version": 1, "description": null }, "density": "balanced", "densityScore": 40, "componentCount": 6, "textChars": 1156, "nDataPoints": 0, "notes": "The slide uses a 'villain_critique' approach by quoting an ex-employee to expose what the author considers to be fraudulent medical claims.", "elementsJson": [ "paragraph", "quote_block", "footnote" ], "confidence": 0.95, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:12:28.667+00", "seconds": 3.878, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/175", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-175", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "Most organs placed on the TransMedics pump, we believe based upon research interviews, fail to meet the labeled criteria of organ viability – rendering the entire DCD use case a scam.", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:12+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a97f-4aa09b3cb5d4", "parentComponentId": null }, { "bbox": { "h": 0.5, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "paragraph", "text": "Most organs placed on the TransMedics pump, we believe based upon research interviews, fail to meet the labeled criteria of organ viability – rendering the entire DCD use case a scam.", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:28.667+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "14eeffdc-02a3-4ae8-be84-45ea3f4ba4a1", "parentComponentId": null }, { "bbox": { "h": 0.15, "w": 0.86, "x": 0.07, "y": 0.6 }, "kind": "quote", "text": "The organs on the OCS device are just as if they were in a human body... the organ is actually in better condition than it was when it was removed from the donor's body. It actually has a therapeutic impact.", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:28.667+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "511348a8-234a-4311-97d0-4f3ecdb5395a", "parentComponentId": null }, { "bbox": { "h": 0.15, "w": 0.86, "x": 0.07, "y": 0.78 }, "kind": "quote", "text": "when the organ is on the device, it's actually recovering... it's in better condition than it was before it went on the device. There is no limitation, even regulatory limitation, on how long the organ can be on the machine.", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:28.667+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "5f30285e-4e65-4d42-bb69-20d9f3b44bee", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "The organs on the OCS device are just as if they were in a human body...the organ is actually in better condition than it was when it was removed from the donor's body. It actually has a therapeutic impact. — Ex senior employee at Transmedics", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:12+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a97f-4e8ab0240965", "parentComponentId": null }, { "bbox": { "h": 0.03, "w": 0.5, "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts; https://www.accessdata.fda.gov/cdrh_docs/pdf20/P200031B.pdf", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:28.667+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "a4e58004-946c-4cce-a1b8-df4da0156234", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [ { "matchId": "49cc82d1-9e1f-4347-86a5-152a0963a6db", "evidence": "The slide explicitly labels the company's business model as a 'scam' and uses internal quotes to prove it.", "framework": null, "confidence": 0.9, "extraction": { "at": "2026-05-02 20:12:28.667+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 175, "frameworkName": "fraud-exposure" } ], "arcBeats": [], "loops": [], "locked": true }, { "page": 176, "type": "tension", "title": "The slide uses a table from a JAMA Surgery paper to highlight the mean donor age in the trial (45.9 years) as evidence of selection bias.", "function": "expose_contradiction", "rawType": "expose_contradiction", "block": null, "metadata": { "slideType": "expose_contradiction", "slideTypeCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-124c-75aa-984a-0a3d0d8fc8df", "version": 1, "description": null }, "function": "expose_contradiction", "functionCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-171f-776f-887c-73edaff4cf9c", "version": 1, "description": null }, "density": "dense", "densityScore": 59, "componentCount": 7, "textChars": 1310, "nDataPoints": 8, "notes": "The slide uses a table from a JAMA Surgery paper to highlight the mean donor age in the trial (45.9 years) as evidence of selection bias.", "elementsJson": [ "paragraph", "data_table" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 21:25:50.001+00", "seconds": 3.22, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/176", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-176", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "the trial cherrypicked the best donors to manipulate the outcomes on the pump.", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:13+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a97f-d687fc27f3be", "parentComponentId": null }, { "bbox": null, "kind": "metric", "text": "Mean donor age: 45.9", "attrs": null, "canon": { "kind": { "name": "Metric", "slug": "metric", "status": "active", "canonId": "019de52c-f923-73bf-8081-d0b1a8c5264d", "version": 1, "description": "Big-number or KPI value." }, "tool": { "name": "Quantification", "slug": "quantification", "status": "active", "bestFor": null, "canonId": "019dd9e1-47ab-72ce-a079-aab1f5299e88", "version": 1, "bodyDocId": null, "description": "Translating a claim into numbers, charts, or tables.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": "primary", "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:13+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a97f-de8fc5a052ae", "parentComponentId": null }, { "bbox": { "h": 0.35, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "paragraph", "text": "The three labeled criteria for use, which most DCD’s livers fail to meet, are 1) the DCD donor is ≤55 years old; 2) ≤30 minutes of warm ischemic time; 3) ≤15% macrosteatotis. The age indication is self-explanatory. The older the donor, the more compromised and high-risk the liver. The average donor age in the pivotal PROTECT trial for OCS Liver was 45.9 years, well below the labeled age, as the trial cherrypicked the best donors to manipulate the outcomes on the pump. However, one high-volume TransMedics center after another told us that most of their device use is for liver donors well over 55 – into their 60’s and older. One such “super user” alleged that Houston Methodist, who we think is one of top two users, is “in the business of transplanting people with 70-year-old livers.”", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:25:50.001+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "37a3b616-1822-4089-88d9-f6cd1603b3cd", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "“in the business of transplanting people with 70-year-old livers.” — One such “super user” regarding Houston Methodist", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:13+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a97f-da1f6079ac84", "parentComponentId": null }, { "bbox": { "h": 0.02, "w": 0.55, "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts; https://www.accessdata.fda.gov/cdrh_docs/pdf20/P200031B.pdf", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:25:50.001+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "10a9b5f8-04ec-4724-9dc3-7d384805c3ea", "parentComponentId": null }, { "bbox": { "h": 0.35, "w": 0.86, "x": 0.07, "y": 0.49 }, "kind": "table", "text": "Table. Donor and Recipient Demographic Characteristics and Risk Factors for Transplanted Organs and Recipients", "attrs": null, "canon": { "kind": { "name": "Table", "slug": "table", "status": "active", "canonId": "019de52c-f9c8-7148-8119-eaac9594cd28", "version": 1, "description": "Tabular data layout." }, "tool": null, "subkind": { "name": "Data table", "slug": "data", "status": "active", "canonId": "019de52d-02d5-75b8-8abf-88e92bf63569", "version": 1, "description": null }, "framework": null }, "subkind": "data", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:25:50.001+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "81720e80-a7d4-477d-8d58-b9edfbb0c966", "parentComponentId": null }, { "bbox": { "h": 0.03, "w": 0.65, "x": 0.07, "y": 0.44 }, "kind": "title", "text": "Donor age - OCS Liver PROTECT pivotal trial, JAMA Surgery paper, March 2022", "attrs": null, "canon": { "kind": { "name": "Title", "slug": "title", "status": "active", "canonId": "019de52c-f7dd-76d9-b848-b1f12bd85cf4", "version": 1, "description": "Slide title or headline." }, "tool": null, "subkind": { "name": "Subtitle", "slug": "subtitle", "status": "active", "canonId": "019de52c-fb09-739d-900c-815b0d9ac526", "version": 1, "description": null }, "framework": null }, "subkind": "subtitle", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:25:50.001+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "9bd8c5bf-f2dc-4451-b02c-03c1198334e7", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [ { "matchId": "8497438a-85b7-4a1c-a27a-cbff907be1b8", "evidence": "The slide explicitly claims the trial 'cherrypicked' donors to 'manipulate the outcomes'.", "framework": null, "confidence": 0.9, "extraction": { "at": "2026-05-02 21:25:50.001+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 176, "frameworkName": "fraud-exposure" } ], "arcBeats": [], "loops": [], "locked": true }, { "page": 177, "type": "setup", "title": "Includes a Q&A transcript excerpt highlighting the risks of off-label use beyond the 30-minute window.", "function": "preempt_rebuttal", "rawType": "preempt_rebuttal", "block": null, "metadata": { "slideType": "preempt_rebuttal", "slideTypeCanon": { "name": "Preempt rebuttal", "slug": "preempt_rebuttal", "status": "active", "canonId": "019de52d-1225-7368-af32-6381fddabdb3", "version": 1, "description": null }, "function": "preempt_rebuttal", "functionCanon": { "name": "Preempt rebuttal", "slug": "preempt_rebuttal", "status": "active", "canonId": "019de52d-18ab-7479-9a7e-820a2f03586a", "version": 1, "description": null }, "density": "dense", "densityScore": 55, "componentCount": 6, "textChars": 2984, "nDataPoints": 0, "notes": "Includes a Q&A transcript excerpt highlighting the risks of off-label use beyond the 30-minute window.", "elementsJson": [ "paragraph", "callout_box", "footnote" ], "confidence": 0.95, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:12:30.714+00", "seconds": 5.438, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/177", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-177", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": { "h": 0.05, "w": 0.86, "x": 0.07, "y": 0.59 }, "kind": "callout", "text": "Most DCD's have excessive warm ischemic time; organs deteriorate rapidly after 30 minutes and unrecoverable", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": null, "subkind": { "name": "Primary callout", "slug": "primary", "status": "active", "canonId": "019de52c-fbd1-70eb-a9ce-8997f8674c1d", "version": 1, "description": null }, "framework": null }, "subkind": "primary", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:30.714+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "413325d2-6199-4876-9d7e-00fa22d86753", "parentComponentId": null }, { "bbox": { "h": 0.28, "w": 0.86, "x": 0.07, "y": 0.65 }, "kind": "paragraph", "text": "Q: “As far as somebody like Mark Ghobrial and these heavy TransMedics users, how much off-label use is there? The label says less than 55 years old. How much of the use is more than 55 years old? It says less than 30 minutes of warm ischemic time. By the way, what does that mean—30 minutes of warm ischemic time?”\nA: “This is an interesting area because this relates to DCD's, donation after cardiac death. There's a period of time when after the life support is removed and before the heart stops; that period is called “donor warm ischemia time.” From the time of withdrawal from life support to the heart-stopping, it's variable and depends on a number of things. If that period of time exceeds 30 minutes, generally, we just walk away from the donor, at least for that organ. What happens is two out of three DCD's never die in time. So, that 30 minutes relates to that period of time we call “donor warm ischemia time” in DCD's. What we're seeing is the expansion of the pump's use - certainly, older than 55, for sure, and pushing the 30 minutes to longer, we don't know. I've heard people doing it, but I also don't think it's going to be pushed much more than 35 to 40 minutes because the organ deteriorates very quickly, almost exponentially, once you get past a certain point, and that point being 30 minutes. If you try to get an organ out and use it for 50 minutes, it'll never work. It doesn't matter what you put into it.” - One of the top liver transplant surgeons in the world, based at a leading Midwest academic center", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:30.714+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "3250103d-6107-4225-983e-3f0948912725", "parentComponentId": null }, { "bbox": { "h": 0.35, "w": 0.86, "x": 0.07, "y": 0.22 }, "kind": "paragraph", "text": "The duration is of paramount importance, as prolonging it causes cellular injury and higher complications such as liver failure or ischemic cholangiopathy. One of the world's top liver transplant surgeons - who is sharply critical of and refuses to use TransMedics - told us that “two out of three DCD's never die in time” – meaning that the warm ischemic period exceeds 30 minutes, a key reason why DCD organs were rarely used prior to TransMedics: “if that period of time exceeds 30 minutes...we just walk away from the donor.” He stated that the organ “deteriorates very quickly, almost exponentially” at 30 minutes...if you try to get an organ our and use it for 50 minutes, it’ll never work...it doesn’t matter what you put into it.”", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:30.714+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "7a464226-b084-4dbf-bd7a-68390f30fc6d", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "“two out of three DCD's never die in time”... “if that period of time exceeds 30 minutes...we just walk away from the donor.”... “deteriorates very quickly, almost exponentially” at 30 minutes...if you try to get an organ our and use it for 50 minutes, it’ll never work...it doesn’t matter what you put into it.” — One of the top liver transplant surgeons in the world, based at a leading Midwest academic center", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:12+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a97f-64b6e06c88ad", "parentComponentId": null }, { "bbox": { "h": 0.02, "w": 0.3, "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:30.714+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "cf58d002-4431-4033-8e1e-f949d465d13b", "parentComponentId": null }, { "bbox": { "h": 0.15, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "title", "text": "The second indication on the label - ≤30 minutes of warm ischemic time - is a critical concept in donors after circulatory death (DCD)", "attrs": null, "canon": { "kind": { "name": "Title", "slug": "title", "status": "active", "canonId": "019de52c-f7dd-76d9-b848-b1f12bd85cf4", "version": 1, "description": "Slide title or headline." }, "tool": null, "subkind": { "name": "Headline", "slug": "headline", "status": "active", "canonId": "019de52c-fae1-7463-9a7c-d60668eced0d", "version": 1, "description": null }, "framework": null }, "subkind": "headline", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:30.714+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "e7ab8959-d125-403b-bd0d-4cc5511281b3", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [], "arcBeats": [], "loops": [], "locked": true }, { "page": 178, "type": "setup", "title": "The slide uses expert quotes to argue that off-label use of perfusion pumps is limited by reputational risk and biological constraints.", "function": "preempt_rebuttal", "rawType": "preempt_rebuttal", "block": null, "metadata": { "slideType": "preempt_rebuttal", "slideTypeCanon": { "name": "Preempt rebuttal", "slug": "preempt_rebuttal", "status": "active", "canonId": "019de52d-1225-7368-af32-6381fddabdb3", "version": 1, "description": null }, "function": "preempt_rebuttal", "functionCanon": { "name": "Preempt rebuttal", "slug": "preempt_rebuttal", "status": "active", "canonId": "019de52d-18ab-7479-9a7e-820a2f03586a", "version": 1, "description": null }, "density": "balanced", "densityScore": 47, "componentCount": 4, "textChars": 2171, "nDataPoints": 2, "notes": "The slide uses expert quotes to argue that off-label use of perfusion pumps is limited by reputational risk and biological constraints.", "elementsJson": [ "paragraph", "footnote" ], "confidence": 0.95, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:12:29.107+00", "seconds": 3.831, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/178", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-178", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": { "h": 0.15, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "paragraph", "text": "The blunt statement by perhaps the world's top liver transplant surgeon and KOL - that organs deteriorate “exponentially” after 30 minutes of warm ischemic time and cannot be saved - indicates why the label precludes such livers on the pump.", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:29.107+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "0a27cb25-909c-4468-820a-51967a1d712a", "parentComponentId": null }, { "bbox": { "h": 0.2, "w": 0.86, "x": 0.07, "y": 0.22 }, "kind": "paragraph", "text": "However, he noted that “what we’re seeing is the expansion of the pump’s use...and pushing the 30 minutes to longer...we don’t know...I’ve heard people doing it, but I also don’t think it’s going to be pushed much more than 35 to 40 minutes because the organ deteriorates very rapidly”; “I can’t imagine people pushing it for much more than 30 minutes...they would be remiss...the organs they procure are damaged or don’t work, which would be a terrible stain on their reputation...so I don’t think it happens to any great extent.”", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:29.107+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "27f36467-f384-4360-b6b3-90a0f3a10d3a", "parentComponentId": null }, { "bbox": { "h": 0.45, "w": 0.86, "x": 0.07, "y": 0.45 }, "kind": "paragraph", "text": "Would be a “terrible stain on their reputation” to push warm ischemic times past 30 minutes\nQ: “What percentage of uses do you think is over 55? Because that’s technically off-label.\nA: “In all these criteria, age and whatever, I would say at least 25%. It may be even higher than that, but it’s not 50%. Between 25% and 35%.”\nQ: “The bulk of that is driven by patients being more than 55 years old or more than 30 minutes of warm ischemic time.\nA: “Yes, probably age. Probably not warm ischemia time. I can’t imagine people pushing it for much more than 30 minutes...They would be remiss - lowering the threshold of quality to the point where the organs that they procure are damaged or don’t work, which would be a terrible stain on their reputation. So, I don’t think it happens to any great extent, pushing the boundaries outside the age. And the age thing, I think, is it works at 50, it works at 55, it works at 57, it works at 60. But I don’t think they’re going to be going up into the 65, 70-year-olds. The problem is that the national registry, the UNOS database, doesn’t collect information about the perfusion machine or the perfusion time or some of the parameters that we think are very important, like donor warm ischemia time.” - One of the top liver transplant surgeons in the world, based at a leading Midwest academic center", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:29.107+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "62cf1744-0421-4a8d-8be4-777aba45a4c3", "parentComponentId": null }, { "bbox": { "h": 0.02, "w": 0.25, "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:29.107+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "ee64a93f-1931-4007-b57b-0230762ed1d1", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [ { "matchId": "73790b53-80ac-40c6-a79d-ac4337f9f989", "evidence": "Uses quotes from a top liver transplant surgeon to validate the argument.", "framework": null, "confidence": 0.9, "extraction": { "at": "2026-05-02 20:12:29.107+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 178, "frameworkName": "authority-citation" } ], "arcBeats": [], "loops": [], "locked": true }, { "page": 179, "type": "tension", "title": "The slide uses a Q&A transcript format to highlight the discrepancy between regulatory guidelines and real-world surgical behavior.", "function": "expose_contradiction", "rawType": "expose_contradiction", "block": null, "metadata": { "slideType": "expose_contradiction", "slideTypeCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-124c-75aa-984a-0a3d0d8fc8df", "version": 1, "description": null }, "function": "expose_contradiction", "functionCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-171f-776f-887c-73edaff4cf9c", "version": 1, "description": null }, "density": "balanced", "densityScore": 40, "componentCount": 5, "textChars": 1176, "nDataPoints": 3, "notes": "The slide uses a Q&A transcript format to highlight the discrepancy between regulatory guidelines and real-world surgical behavior.", "elementsJson": [ "paragraph", "quote_block", "footnote" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 21:25:52.039+00", "seconds": 5.166, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/179", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-179", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "The concentrated group of “super users” who drive TransMedics revenue regularly, we were told, push the period far beyond 30 minutes, to 2 hours or more.", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:12+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a97f-90eabd8328a7", "parentComponentId": null }, { "bbox": { "h": 0.35, "w": 0.86, "x": 0.07, "y": 0.58 }, "kind": "list", "text": "Q: You said extended warm times... How far are you able to successfully push that? A: ...we've waited two hours... We wait 45 minutes. Q: What was the rationale... A: ...significant increase in the rate of complications... Q: What percentage... A: ...more than 50% are over 30 minutes.", "attrs": null, "canon": { "kind": { "name": "List", "slug": "list", "status": "active", "canonId": "019de52c-f94b-779b-a53b-fd4904a5f4d2", "version": 1, "description": "Bullet or numbered list." }, "tool": null, "subkind": { "name": "Bullet list", "slug": "bullet", "status": "active", "canonId": "019de52c-fc98-7169-a083-5cab805076ca", "version": 1, "description": null }, "framework": null }, "subkind": "bullet", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:25:52.039+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "ac2089b5-e582-4b3e-8ba2-7ded66665aee", "parentComponentId": null }, { "bbox": { "h": 0.45, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "paragraph", "text": "The surgeon’s speculation – that very few device users would be reckless enough to push the warm ischemic time beyond 30 minutes... is naïve and merely the tip of the iceberg.", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:25:52.039+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "7bb45de7-dd1f-4851-983a-7229a0cf8695", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "“the problem is that the national registry, the UNOS database, doesn’t collect information about...the perfusion time or some of the parameters we think are very important, like donor warm ischemia time.” — KOL; “more than 50% [of donor livers] are over 30 minutes” and that “we’ve waited two hours...we wait 45 minutes” — TransMedics’ highest-volume user; “the rationale is you had a significant increase in the rate of complications...where the liver just doesn’t work.” — TransMedics’ highest-volume user", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:12+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a97f-968388898e28", "parentComponentId": null }, { "bbox": { "h": 0.03, "w": 0.3, "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:25:52.039+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "e414d317-d107-4841-850d-fafc448cd00a", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [ { "matchId": "59585f7b-6164-4d0d-906b-b25d2fe0a347", "evidence": "The text explicitly mentions 'merely the tip of the iceberg' to describe the gap between stated guidelines and actual practice.", "framework": null, "confidence": 0.9, "extraction": { "at": "2026-05-02 21:25:52.039+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 179, "frameworkName": "iceberg-model" } ], "arcBeats": [], "loops": [], "locked": true }, { "page": 180, "type": "tension", "title": "The slide uses a specific study to challenge the safety/efficacy claims of machine perfusion vendors like TransMedics.", "function": "expose_contradiction", "rawType": "expose_contradiction", "block": null, "metadata": { "slideType": "expose_contradiction", "slideTypeCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-124c-75aa-984a-0a3d0d8fc8df", "version": 1, "description": null }, "function": "expose_contradiction", "functionCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-171f-776f-887c-73edaff4cf9c", "version": 1, "description": null }, "density": "dense", "densityScore": 69, "componentCount": 8, "textChars": 2451, "nDataPoints": 0, "notes": "The slide uses a specific study to challenge the safety/efficacy claims of machine perfusion vendors like TransMedics.", "elementsJson": [ "paragraph", "screenshot" ], "confidence": 0.95, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:12:34.245+00", "seconds": 8.507, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/180", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-180", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": { "h": 0.03, "w": 0.5, "x": 0.07, "y": 0.58 }, "kind": "callout", "text": "Dec 2024 study on liver damage from warm perfusion machines", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": null, "subkind": { "name": "Primary callout", "slug": "primary", "status": "active", "canonId": "019de52c-fbd1-70eb-a9ce-8997f8674c1d", "version": 1, "description": null }, "framework": null }, "subkind": "primary", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:34.245+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "6eb4a03a-1467-499c-8e1a-123de31cbe11", "parentComponentId": null }, { "bbox": { "h": 0.05, "w": 0.3, "x": 0.5, "y": 0.86 }, "kind": "callout", "text": "“a comprehensive mechanistic assessment of NMP is still lacking”", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": null, "subkind": { "name": "Primary callout", "slug": "primary", "status": "active", "canonId": "019de52c-fbd1-70eb-a9ce-8997f8674c1d", "version": 1, "description": null }, "framework": null }, "subkind": "primary", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:34.245+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "8c687d64-4aae-4976-b56a-70d36af7a60c", "parentComponentId": null }, { "bbox": null, "kind": "callout", "text": "Machine perfusion vendors like TransMedics would jeopardize their existence by studying such damage, but we note emerging studies like one just published in Dec 2024 measuring biomarker concentration in perfusate samples from a pump", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:12+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a97f-1bbd53682339", "parentComponentId": null }, { "bbox": { "h": 0.5, "w": 0.85, "x": 0.07, "y": 0.07 }, "kind": "paragraph", "text": "Closely related to warm ischemic time is the time the organ is on the pump. Although time on pump is not explicitly indicated on the label, it was a key measure in the pivotal trial and FDA approval. The OCS Liver PROTECT trial doesn't appear to specify the average pump duration, but surgeons indicated it was short – around 6 hours, with some up to 8-10 – given damage the longer a liver is perfused outside a body. Our review of the clinical literature indicates significant organ damage with extended warm perfusion periods >10 hours, such as hepatocellular damage, reperfusion injury, and histological changes. Machine perfusion vendors like TransMedics would jeopardize their existence by studying such damage, but we note emerging studies like one just published in Dec 2024 measuring biomarker concentration in perfusate samples from a pump – showing \"significant accumulation of markers\" for injury and pathological processes; \"a self-perpetuating cycle of inflammation and additional cell damage\"; \"which may limit the extent of benefit of this technology....\"", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:34.245+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "905e0f1f-8eb3-455a-97eb-f7e3726ea6fa", "parentComponentId": null }, { "bbox": { "h": 0.15, "w": 0.4, "x": 0.07, "y": 0.75 }, "kind": "paragraph", "text": "studied. Normothermic machine perfusion (NMP) tries to rebalance cellular metabolism by maintaining the organ at physiological temperature and also supplying oxygen and nutrients. Although these conditions may allow viability assessment before using these organs for liver transplantation (LT), a comprehensive mechanistic assessment of NMP is still lacking. Moreover, this is an essential step toward identifying biomarkers to assess and predict liver function and viability after LT.", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:34.245+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "b302df13-1aa0-4329-827d-36b26b9751ae", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "“significant accumulation of markers” for injury and pathological processes; “a self-perpetuating cycle of inflammation and additional cell damage”; “which may limit the extent of benefit of this technology….” — Dec 2024 study on liver damage from warm perfusion machines", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:12+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a97f-1da065967055", "parentComponentId": null }, { "bbox": { "h": 0.03, "w": 0.8, "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts; https://journals.lww.com/transplantationdirect/fulltext/2024/12000/dynamics_of_ischemia_reperfusion_injury_markers.8.aspx", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:34.245+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "fb251c1c-3b03-4f26-a0ff-d686fad8ff76", "parentComponentId": null }, { "bbox": { "h": 0.1, "w": 0.8, "x": 0.07, "y": 0.62 }, "kind": "title", "text": "Dynamics of Ischemia/Reperfusion Injury Markers During Normothermic Liver Machine Perfusion", "attrs": null, "canon": { "kind": { "name": "Title", "slug": "title", "status": "active", "canonId": "019de52c-f7dd-76d9-b848-b1f12bd85cf4", "version": 1, "description": "Slide title or headline." }, "tool": null, "subkind": { "name": "Headline", "slug": "headline", "status": "active", "canonId": "019de52c-fae1-7463-9a7c-d60668eced0d", "version": 1, "description": null }, "framework": null }, "subkind": "headline", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:34.245+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "7cfeb958-0f4b-44e7-b97e-1468852cde66", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [], "arcBeats": [], "loops": [], "locked": true }, { "page": 181, "type": "tension", "title": "The slide uses a combination of narrative summary and verbatim Q&A transcripts to highlight discrepancies between trial conditions and real-world usage.", "function": "expose_contradiction", "rawType": "expose_contradiction", "block": null, "metadata": { "slideType": "expose_contradiction", "slideTypeCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-124c-75aa-984a-0a3d0d8fc8df", "version": 1, "description": null }, "function": "expose_contradiction", "functionCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-171f-776f-887c-73edaff4cf9c", "version": 1, "description": null }, "density": "dense", "densityScore": 53, "componentCount": 5, "textChars": 2291, "nDataPoints": 6, "notes": "The slide uses a combination of narrative summary and verbatim Q&A transcripts to highlight discrepancies between trial conditions and real-world usage.", "elementsJson": [ "paragraph", "quote_block", "footnote" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:12:29.491+00", "seconds": 3.59, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/181", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-181", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "He questioned the transplant outcomes with long pump times – \"and that’s a problem...it’s very hard to get the data...because they’re not collecting it.\"", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:13+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a97f-aba14970344c", "parentComponentId": null }, { "bbox": { "h": 0.48, "w": 0.86, "x": 0.07, "y": 0.45 }, "kind": "list", "text": "Lives on pump up to 40 hours... Extended times on pump are reckless and were not studied in the trial", "attrs": null, "canon": { "kind": { "name": "List", "slug": "list", "status": "active", "canonId": "019de52c-f94b-779b-a53b-fd4904a5f4d2", "version": 1, "description": "Bullet or numbered list." }, "tool": null, "subkind": { "name": "Bullet list", "slug": "bullet", "status": "active", "canonId": "019de52c-fc98-7169-a083-5cab805076ca", "version": 1, "description": null }, "framework": null }, "subkind": "bullet", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:29.491+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "7a15ff00-a585-4dcd-8720-12248a856753", "parentComponentId": null }, { "bbox": { "h": 0.35, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "paragraph", "text": "A ex-employee at TransMedics boasted to us that livers retrieved via their NOP program are often on the pump for 40 hours, with the average being “at least 10-11 hours”; while doctors are “getting their beauty sleep, our clinical specialist is sitting right next to the machine with the organ...so, it’s kind of weird.” He added that few centers use the heart pump and NOP because it’s simply too slow – “they’re used to four hours, and if it’s over eight hours, they start to get a little edgy.” A leading liver transplant KOL indicated users are pumping past 20 hours and that anything over 12-15 hours is “pushing it” and that the pivotal trial times on pump were half that or less. He questioned the transplant outcomes with long pump times – “and that’s a problem...it’s very hard to get the data...because they’re not collecting it.”", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:29.491+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "262dd1c2-2ea6-40ae-b409-ee137c365937", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "\"For liver, some of our missions last up to 40 hours - probably like 28 or 30 hours on OCS. Because the doctors are so comfortable with the machine now, they are not in a rush. While they're sleeping and getting their beauty sleep, our clinical specialist is sitting right next to the machine with the organ. so, it's kind of weird. So, on some of these missions, our clinical specialists are gone up to 40 hours long because there's no rush for procurement.\" — Ex-employee at Transmedics; \"Once you get past about 12 to 15 hours, you're pushing it. Those machine devices are in the pivotal trials, you look at that, and they were in the 6 to 8 to 10-hour range. So, if you get past the 50% increase, you're up to 15 hours; I think you might say that's excessive. And I've seen people push it to in the 20-hour range. I don't know what the outcomes are, so it'll be up to somebody to do a deep dive analysis about the outcomes. And that's a problem; it's very hard to get the data out of the current system because they're not collecting it.\" — One of the top liver transplant surgeons in the world, based at a leading Midwest academic center", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:13+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a97f-ad3706b61d83", "parentComponentId": null }, { "bbox": { "h": 0.02, "w": 0.3, "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:29.491+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "dbf3dcad-94b2-4fcc-84d4-60ecaf0d7aa7", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [ { "matchId": "26166196-9b2c-4c39-9d97-226d67fe5897", "evidence": "The slide explicitly highlights discrepancies between trial data and real-world usage to question company claims and safety.", "framework": null, "confidence": 0.9, "extraction": { "at": "2026-05-02 20:12:29.491+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 181, "frameworkName": "fraud-exposure" } ], "arcBeats": [], "loops": [], "locked": true }, { "page": 182, "type": "setup", "title": "The slide uses excerpts from clinical literature to define the risks of transplanting steatotic livers.", "function": "establish_context", "rawType": "appendix_methodology", "block": null, "metadata": { "slideType": "appendix_methodology", "slideTypeCanon": { "name": "Appendix methodology", "slug": "appendix_methodology", "status": "active", "canonId": "019de52d-07d9-726c-8599-167f2d2ffaa7", "version": 1, "description": null }, "function": "establish_context", "functionCanon": { "name": "Establish context", "slug": "establish_context", "status": "active", "canonId": "019de52d-1314-74e6-9074-d213dc0bdcdf", "version": 1, "description": null }, "density": "overcrowded", "densityScore": 85, "componentCount": 10, "textChars": 2037, "nDataPoints": 4, "notes": "The slide uses excerpts from clinical literature to define the risks of transplanting steatotic livers.", "elementsJson": [ "paragraph", "footnote" ], "confidence": 0.9, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:12:29.225+00", "seconds": 3.318, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/182", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-182", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": { "h": 0.03, "w": 0.86, "x": 0.07, "y": 0.41 }, "kind": "callout", "text": "Clinical literature on steatotic liver outcomes – Transplantation journal, 2020 and 2023 papers", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": null, "subkind": { "name": "Primary callout", "slug": "primary", "status": "active", "canonId": "019de52c-fbd1-70eb-a9ce-8997f8674c1d", "version": 1, "description": null }, "framework": null }, "subkind": "primary", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:29.225+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "5d0f817b-fd34-4e20-8741-d91e03a2f608", "parentComponentId": null }, { "bbox": null, "kind": "callout", "text": "The clinical literature is unequivocal, per another study: \"steatotis in the donor liver has been identified as a predictor of graft failure...so these livers are often considered...marginal....\"", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:12+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a97f-0106b5b174f7", "parentComponentId": null }, { "bbox": { "h": 0.15, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "paragraph", "text": "The third labeled criteria for OCS Liver is ≤15% macrosteatotis, which refers to a low level of fat accumulation, as even mild levels of liver fat ~5% pose risks, while levels >20-30% lead to substantially higher levels of transplant failure.", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:29.225+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "0d051524-d622-4216-b722-592fce7e4107", "parentComponentId": null }, { "bbox": { "h": 0.08, "w": 0.86, "x": 0.07, "y": 0.57 }, "kind": "paragraph", "text": "Donor livers with ≥30% macrosteatosis (steatotic livers) represent a possible expansion to the donor pool, but are frequently discarded as they are associated with an increased risk of mortality and graft loss. We hypothesized that there are certain recipient phenotypes that", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:29.225+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "37834fed-73d6-4582-80ed-0b535530c582", "parentComponentId": null }, { "bbox": { "h": 0.08, "w": 0.86, "x": 0.07, "y": 0.81 }, "kind": "paragraph", "text": "Macrovesicular steatosis in the donor liver has been identified as a predictor of graft failure, and so these livers are often considered extended criteria or marginal livers.2 Previous studies have demonstrated an association", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:29.225+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "4fb87c87-fd11-4292-a9e4-e9ce0d366f09", "parentComponentId": null }, { "bbox": { "h": 0.15, "w": 0.86, "x": 0.07, "y": 0.22 }, "kind": "paragraph", "text": "One study found 2-3-fold higher odds of death in patients receiving macrosteatotic livers versus those with non-steatotic grafts. Livers with 30% macrosteatosis are “frequently discarded as they are associated with an increased risk of mortality and graft loss. The clinical literature is unequivocal, per another study: “steatotis in the donor liver has been identified as a predictor of graft failure...so these livers are often considered...marginal....”", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:29.225+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "e9c37290-a1eb-4fdb-b727-e11b9859a407", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "“frequently discarded as they are associated with an increased risk of mortality and graft loss.” — Transplantation journal", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:12+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a97f-069b7efbd0a4", "parentComponentId": null }, { "bbox": { "h": 0.04, "w": 0.86, "x": 0.07, "y": 0.94 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts; https://pmc.ncbi.nlm.nih.gov/articles/PMC7237292/; https://srtr.org/media/1617/kwong-transplantation-2023-impact-of-donor-liver-macrovesicular-steatosis-on-deceased.pdf", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:29.225+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "81852c17-6394-4fd2-be5e-70c02c0f6f55", "parentComponentId": null }, { "bbox": { "h": 0.08, "w": 0.56, "x": 0.07, "y": 0.7 }, "kind": "title", "text": "Impact of Donor Liver Macrovesicular Steatosis on Deceased Donor Yield and Posttransplant Outcome", "attrs": null, "canon": { "kind": { "name": "Title", "slug": "title", "status": "active", "canonId": "019de52c-f7dd-76d9-b848-b1f12bd85cf4", "version": 1, "description": "Slide title or headline." }, "tool": null, "subkind": { "name": "Headline", "slug": "headline", "status": "active", "canonId": "019de52c-fae1-7463-9a7c-d60668eced0d", "version": 1, "description": null }, "framework": null }, "subkind": "headline", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:29.225+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "081c94b5-27d7-429c-a350-bdaa6f2cd1f5", "parentComponentId": null }, { "bbox": { "h": 0.08, "w": 0.56, "x": 0.07, "y": 0.45 }, "kind": "title", "text": "Minimizing Risks of Liver Transplantation With Steatotic Donor Livers by Preferred Recipient Matching", "attrs": null, "canon": { "kind": { "name": "Title", "slug": "title", "status": "active", "canonId": "019de52c-f7dd-76d9-b848-b1f12bd85cf4", "version": 1, "description": "Slide title or headline." }, "tool": null, "subkind": { "name": "Headline", "slug": "headline", "status": "active", "canonId": "019de52c-fae1-7463-9a7c-d60668eced0d", "version": 1, "description": null }, "framework": null }, "subkind": "headline", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:29.225+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "f648a5fd-5b9d-4a0d-b72d-9ab2ca74fddd", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [], "arcBeats": [], "loops": [], "locked": true }, { "page": 183, "type": "tension", "title": "The slide uses direct quotes from a transplant surgeon to expose potential malpractice or dangerous usage patterns.", "function": "expose_contradiction", "rawType": "expose_contradiction", "block": null, "metadata": { "slideType": "expose_contradiction", "slideTypeCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-124c-75aa-984a-0a3d0d8fc8df", "version": 1, "description": null }, "function": "expose_contradiction", "functionCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-171f-776f-887c-73edaff4cf9c", "version": 1, "description": null }, "density": "balanced", "densityScore": 40, "componentCount": 6, "textChars": 955, "nDataPoints": 2, "notes": "The slide uses direct quotes from a transplant surgeon to expose potential malpractice or dangerous usage patterns.", "elementsJson": [ "paragraph", "quote_block", "footnote" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:12:29.325+00", "seconds": 2.955, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/183", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-183", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "you can push it up to about 50%...the problem is that the fat doesn't transplant well, but if you can re-perfuse it and let the organ calm down on the TransMedics pump...then all that fat washes out over the next couple of weeks.", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:13+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a980-1f3201274998", "parentComponentId": null }, { "bbox": { "h": 0.25, "w": 0.86, "x": 0.07, "y": 0.65 }, "kind": "list", "text": "Increasingly using for fatty livers in addition to those with diabetes and metabolic syndrome", "attrs": null, "canon": { "kind": { "name": "List", "slug": "list", "status": "active", "canonId": "019de52c-f94b-779b-a53b-fd4904a5f4d2", "version": 1, "description": "Bullet or numbered list." }, "tool": null, "subkind": { "name": "Bullet list", "slug": "bullet", "status": "active", "canonId": "019de52c-fc98-7169-a083-5cab805076ca", "version": 1, "description": null }, "framework": null }, "subkind": "bullet", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:29.325+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "7562ab44-88ae-4c71-bef3-2a1462ace478", "parentComponentId": null }, { "bbox": { "h": 0.25, "w": 0.86, "x": 0.07, "y": 0.35 }, "kind": "list", "text": "High volume user putting livers with ~50% steatotis on pump despite stating >20% is worrisome", "attrs": null, "canon": { "kind": { "name": "List", "slug": "list", "status": "active", "canonId": "019de52c-f94b-779b-a53b-fd4904a5f4d2", "version": 1, "description": "Bullet or numbered list." }, "tool": null, "subkind": { "name": "Bullet list", "slug": "bullet", "status": "active", "canonId": "019de52c-fc98-7169-a083-5cab805076ca", "version": 1, "description": null }, "framework": null }, "subkind": "bullet", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:29.325+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "b1b53e67-9aee-4d92-a7a1-a3c8557a31c8", "parentComponentId": null }, { "bbox": { "h": 0.25, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "paragraph", "text": "Predictably, the third area where high-volume TransMedics users blatantly and openly disregard the FDA label for the pump is the off-label misuse of highly fatty/steatotic livers...", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:29.325+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "7cbbb437-48eb-4556-9eb8-3b885781ff93", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "a lot of centers are using it...the livers are fatty, metabolic syndrome, type 2 diabetes...the livers get replaced with fat...if it stays greater than 20% fat...then the liver doesn't tolerate the transplant very well. — Transplant surgeon and surgical director at a high-volume academic center in Utah", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:13+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a980-228164b5db3b", "parentComponentId": null }, { "bbox": { "h": 0.03, "w": 0.3, "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:29.325+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "90b834ad-de71-4fe1-b8f8-481c629f7fee", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [ { "matchId": "d7de5942-6fbb-4247-bebf-31fc7f53a2e9", "evidence": "The slide explicitly frames the user's behavior as 'textbook quackery' and 'disregard the FDA label' to expose potential misconduct.", "framework": null, "confidence": 0.9, "extraction": { "at": "2026-05-02 20:12:29.325+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 183, "frameworkName": "fraud-exposure" } ], "arcBeats": [], "loops": [], "locked": true }, { "page": 184, "type": "tension", "title": "The slide uses a Q&A transcript format to frame the company's business model as 'quackery' and reliant on 'marginal' organs.", "function": "expose_contradiction", "rawType": "villain_critique", "block": null, "metadata": { "slideType": "villain_critique", "slideTypeCanon": { "name": "Villain critique", "slug": "villain_critique", "status": "active", "canonId": "019de52d-10bc-7136-bf20-09de59d17447", "version": 1, "description": null }, "function": "expose_contradiction", "functionCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-171f-776f-887c-73edaff4cf9c", "version": 1, "description": null }, "density": "overcrowded", "densityScore": 80, "componentCount": 9, "textChars": 2379, "nDataPoints": 1, "notes": "The slide uses a Q&A transcript format to frame the company's business model as 'quackery' and reliant on 'marginal' organs.", "elementsJson": [ "paragraph", "quote_block" ], "confidence": 0.95, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:12:31.485+00", "seconds": 5.02, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/184", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-184", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "By definition, the surgeons that TransMedics depends on are prolific only because they traffic in rejects – under the pretense that the pump magically restores them, the quackery at the heart of TransMedics business model.", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:13+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a97f-c3fa105269ab", "parentComponentId": null }, { "bbox": { "h": 0.03, "w": 0.86, "x": 0.07, "y": 0.64 }, "kind": "list", "text": "Using livers others won’t touch, “very old” donors or “fatty liver”", "attrs": null, "canon": { "kind": { "name": "List", "slug": "list", "status": "active", "canonId": "019de52c-f94b-779b-a53b-fd4904a5f4d2", "version": 1, "description": "Bullet or numbered list." }, "tool": null, "subkind": { "name": "Bullet list", "slug": "bullet", "status": "active", "canonId": "019de52c-fc98-7169-a083-5cab805076ca", "version": 1, "description": null }, "framework": null }, "subkind": "bullet", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:31.485+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "b6a3533b-03c8-467d-805e-b30091eff4e1", "parentComponentId": null }, { "bbox": { "h": 0.1, "w": 0.86, "x": 0.07, "y": 0.22 }, "kind": "paragraph", "text": "By definition, the surgeons that TransMedics depends on are prolific only because they traffic in rejects – under the pretense that the pump magically restores them, the quackery at the heart of TransMedics business model.", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:31.485+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "053436f3-b901-4a70-b7f1-89e6f9011ae3", "parentComponentId": null }, { "bbox": { "h": 0.15, "w": 0.86, "x": 0.07, "y": 0.48 }, "kind": "paragraph", "text": "The surgeon stated that the livers they transplant are “almost always” this marginal to the point you have to be “really, really sick to get a normal liver offer here,” as though needing a transplant is not sick enough – “one was over 70, fatty liver or abnormal lab test, and a lot of people pass...enzymes are a little abnormal...most of them.”", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:31.485+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "70927f33-4331-49fd-ae5c-50ea15b438c2", "parentComponentId": null }, { "bbox": { "h": 0.15, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "paragraph", "text": "Every top TransMedics center told us their volumes are driven by marginal organs that most other centers reject – geriatric donors, excessive warm ischemic time, and fatty. Organs are scarce with ~10,000 patients on the national waiting list for a liver.", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:31.485+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "72d8c5cc-9e26-4d63-a815-8a1ef18a1147", "parentComponentId": null }, { "bbox": { "h": 0.15, "w": 0.86, "x": 0.07, "y": 0.67 }, "kind": "paragraph", "text": "A: “We’re using it for donors who are pretty much challenged...if there’s a good donor that comes up, a young, healthy donor who’s brain dead, you’re going to take that donor; you’re pretty much not going to need to use anything TransMedics or anything else. If you’ve had a lot of people say no to an organ because that donor is not “standard” – they may be very old, over 70 or 65. They may have some problems with their liver like a fatty liver. That’s called DCD, donation after cardiac death. And those livers get many more complications. You have to have a really high score; you have to be really, really sick to get a normal liver offer here.”", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:31.485+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "9d449cf0-698c-4fdd-93ec-90c8f83da4a6", "parentComponentId": null }, { "bbox": { "h": 0.15, "w": 0.86, "x": 0.07, "y": 0.33 }, "kind": "quote", "text": "A head of a major liver transplant program in Pennsylvania is typical: “we’re using it for organs who pretty much challenged...if you’ve had a lot of people say no...because that donor is not ‘standard’....very old, over 70 or 65...some problems...like a fatty liver.”", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:31.485+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "ef442bc9-f7de-492b-a560-563889a7caaa", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "“We’re using it for organs who pretty much challenged...if you’ve had a lot of people say no...because that donor is not ‘standard’....very old, over 70 or 65...some problems...like a fatty liver.” — Transplant surgeon and transplant program director at a major academic center in Pennsylvania", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:13+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a97f-c532c684a752", "parentComponentId": null }, { "bbox": { "h": 0.03, "w": 0.3, "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:31.485+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "773b6ab1-a036-4e3f-9dcf-460390ee4e74", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [], "arcBeats": [], "loops": [], "locked": true }, { "page": 185, "type": "tension", "title": "The slide uses a 'villain' narrative style to frame the company's business practices as risky or non-compliant.", "function": "expose_contradiction", "rawType": "expose_contradiction", "block": null, "metadata": { "slideType": "expose_contradiction", "slideTypeCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-124c-75aa-984a-0a3d0d8fc8df", "version": 1, "description": null }, "function": "expose_contradiction", "functionCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-171f-776f-887c-73edaff4cf9c", "version": 1, "description": null }, "density": "dense", "densityScore": 69, "componentCount": 8, "textChars": 1633, "nDataPoints": 4, "notes": "The slide uses a 'villain' narrative style to frame the company's business practices as risky or non-compliant.", "elementsJson": [ "paragraph", "quote_block" ], "confidence": 0.95, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:12:29.579+00", "seconds": 2.903, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/185", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-185", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "The previous surgeon – who just recently transplanted a liver from a donor over 70, after putting it on the pump – is a hair-raising example of the type of off-label misuse that the TransMedics device has normalized.", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:14+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a980-639acb2afceb", "parentComponentId": null }, { "bbox": { "h": 0.05, "w": 0.86, "x": 0.07, "y": 0.76 }, "kind": "list", "text": "Competitor: Large majority” of donor livers placed on TransMedics are over the age indicated in the label", "attrs": null, "canon": { "kind": { "name": "List", "slug": "list", "status": "active", "canonId": "019de52c-f94b-779b-a53b-fd4904a5f4d2", "version": 1, "description": "Bullet or numbered list." }, "tool": null, "subkind": { "name": "Bullet list", "slug": "bullet", "status": "active", "canonId": "019de52c-fc98-7169-a083-5cab805076ca", "version": 1, "description": null }, "framework": null }, "subkind": "bullet", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:29.579+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "64608953-8a76-40de-8743-9fc5eac1663f", "parentComponentId": null }, { "bbox": { "h": 0.08, "w": 0.86, "x": 0.07, "y": 0.64 }, "kind": "list", "text": "High volume user: 30% of donors in their 60’s; some high volume centers transplanting livers from 70 year olds", "attrs": null, "canon": { "kind": { "name": "List", "slug": "list", "status": "active", "canonId": "019de52c-f94b-779b-a53b-fd4904a5f4d2", "version": 1, "description": "Bullet or numbered list." }, "tool": null, "subkind": { "name": "Bullet list", "slug": "bullet", "status": "active", "canonId": "019de52c-fc98-7169-a083-5cab805076ca", "version": 1, "description": null }, "framework": null }, "subkind": "bullet", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:29.579+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "bac85963-7d3a-4cf8-93e0-423f7456147d", "parentComponentId": null }, { "bbox": { "h": 0.03, "w": 0.86, "x": 0.07, "y": 0.86 }, "kind": "list", "text": "More than half of donors are over 55", "attrs": null, "canon": { "kind": { "name": "List", "slug": "list", "status": "active", "canonId": "019de52c-f94b-779b-a53b-fd4904a5f4d2", "version": 1, "description": "Bullet or numbered list." }, "tool": null, "subkind": { "name": "Bullet list", "slug": "bullet", "status": "active", "canonId": "019de52c-fc98-7169-a083-5cab805076ca", "version": 1, "description": null }, "framework": null }, "subkind": "bullet", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:29.579+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "c5e2992f-5b75-4ee2-bbfb-430ed02fa298", "parentComponentId": null }, { "bbox": { "h": 0.08, "w": 0.86, "x": 0.07, "y": 0.55 }, "kind": "list", "text": "Using for 65 year old donors, most device usage is for “older donors”", "attrs": null, "canon": { "kind": { "name": "List", "slug": "list", "status": "active", "canonId": "019de52c-f94b-779b-a53b-fd4904a5f4d2", "version": 1, "description": "Bullet or numbered list." }, "tool": null, "subkind": { "name": "Bullet list", "slug": "bullet", "status": "active", "canonId": "019de52c-fc98-7169-a083-5cab805076ca", "version": 1, "description": null }, "framework": null }, "subkind": "bullet", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:29.579+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "cafa1665-35d5-49c1-a54c-0b63d5e0ec54", "parentComponentId": null }, { "bbox": { "h": 0.15, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "paragraph", "text": "The previous surgeon – who just recently transplanted a liver from a donor over 70, after putting it on the pump – is a hair-raising example of the type of off-label misuse that the TransMedics device has normalized.", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:29.579+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "47eae53f-fddc-4347-a7d9-8bab93168cee", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "“Up to 65 now is our limit... and who knows, maybe we’ll increase that even further...most people that are using machine perfusion now are using it for older donors.” — Transplant surgeon and transplant program director at a leading Northeast academic center; “30%...the older peak, we’re not in the business of transplanting people with 70-year-old livers, like other places do. I know Methodist does a lot of older donors.” — Transplant hepatologist and director of the liver program at a Midwest academic center; “Yes., 100%...the donors are becoming increasingly older. I would not be surprised if a large majority of folks are above that age range.” — Senior medical employee at OrganOx; “DCDs over the age of 55, I would say, are probably more than 50%.” — Transplant surgeon at a high volume West Coast academic center", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:14+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a980-65e44ccfbf01", "parentComponentId": null }, { "bbox": { "h": 0.03, "w": 0.3, "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:29.579+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "350cb353-913d-48b4-89a7-efb36d141718", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [ { "matchId": "59c9afb5-a522-4089-b2c5-094ff2f6704d", "evidence": "The slide explicitly frames the company's actions as 'off-label misuse' and 'hair-raising' to suggest regulatory or ethical non-compliance.", "framework": null, "confidence": 0.9, "extraction": { "at": "2026-05-02 20:12:29.579+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 185, "frameworkName": "fraud-exposure" } ], "arcBeats": [], "loops": [], "locked": true }, { "page": 186, "type": "tension", "title": "The slide uses expert testimony to challenge the value proposition of the TransMedics technology.", "function": "expose_contradiction", "rawType": "expose_contradiction", "block": null, "metadata": { "slideType": "expose_contradiction", "slideTypeCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-124c-75aa-984a-0a3d0d8fc8df", "version": 1, "description": null }, "function": "expose_contradiction", "functionCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-171f-776f-887c-73edaff4cf9c", "version": 1, "description": null }, "density": "dense", "densityScore": 59, "componentCount": 6, "textChars": 2552, "nDataPoints": 4, "notes": "The slide uses expert testimony to challenge the value proposition of the TransMedics technology.", "elementsJson": [ "paragraph", "quote_block" ], "confidence": 0.95, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:12:32.105+00", "seconds": 5.398, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/186", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-186", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "While TransMedics claims that its pump has grown transplant volumes by making DCD organs usable, the claim is false: DCD's have spiked because OPO's and transplant centers are under pressure to show volume for compliance reasons.", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:13+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a97f-f0973334f87b", "parentComponentId": null }, { "bbox": { "h": 0.45, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "paragraph", "text": "The bull case for TransMedics is that a normothermic pump purportedly enables the use of DCD organs, which are of dubious quality and therefore unused prior to the pump – “historically, DCD livers were utilized, in a gray area, maybe 8% of the time...so very, very low utilization.” While TransMedics claims that its pump has grown transplant volumes by making DCD organs usable, the claim is false: DCD’s have spiked because OPO’s and transplant centers are under pressure to show volume for compliance reasons, with the prospect of smaller OPO’s and centers being shut down or losing their certification – and they have resorted to using organs they would never touch before, not because a pump magically heals them, but because it gives them a pretense. We quote a high volume user: “that’s where and why we started to use because there’s a lot of pressure to transplant our patients...our cut-off was like 30 years old...now we’re going up to 60-65...so it’s increased that dramatically.”", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:32.105+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "8c594428-3ba2-45c7-a4ee-8b8ab50cd440", "parentComponentId": null }, { "bbox": { "h": 0.15, "w": 0.86, "x": 0.07, "y": 0.78 }, "kind": "quote", "text": "Using for 60-65 year-old donors when cut-off was 30, or 40 “if pristine”. “The donors are older because we weren’t accepting DCD livers that were - I think our cut-off was like 30 years old, maybe we considered 40 if they were pristine and, say, a gunshot wound to the head. Now, we’re going up to 60-65. So, it’s increased that dramatically.” – Transplant surgeon and surgical director in Utah", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:32.105+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "6fc5e6bb-15ab-4211-8fc4-ffcb98a16a79", "parentComponentId": null }, { "bbox": { "h": 0.2, "w": 0.86, "x": 0.07, "y": 0.55 }, "kind": "quote", "text": "TransMedics usage due to pressure on OPO's to grow using questionable “gray area” DCD organs. “There’s been a mandate that an OPO’s DCD volume should be between 45% and 50% of total organ donors. Historically, DCD livers were utilized, in a gray area, maybe 8% of the time. So, very, very low utilization. And so, how do you grow? If the OPO is going to continue to increase DCD but you can’t really grow 80% but what the TransMedics does it allows you to use those organs; it resuscitates them. That’s where and why we started to use them because there’s a lot of pressure to transplant our patients.” – Transplant surgeon and surgical director at a high volume academic center in Utah", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:32.105+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "bf1b161d-2d51-4857-b1b0-3bcf9a44fa8c", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "“historically, DCD livers were utilized, in a gray area, maybe 8% of the time...so very, very low utilization.” — Transplant surgeon and surgical director at a high volume academic center in Utah", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:13+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a97f-f79a779986df", "parentComponentId": null }, { "bbox": { "h": 0.03, "w": 0.3, "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:32.105+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "6bd1339f-c26a-41a6-b3fa-b6530a5a0d02", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [ { "matchId": "e27038d7-e6e8-4b05-94cf-6c9808f4e2fc", "evidence": "The slide explicitly contrasts the company's 'bull case' claim with expert testimony that contradicts the underlying mechanism.", "framework": null, "confidence": 0.9, "extraction": { "at": "2026-05-02 20:12:32.105+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 186, "frameworkName": "ceo-quote-contradiction" } ], "arcBeats": [], "loops": [], "locked": true }, { "page": 187, "type": "tension", "title": "The slide uses a direct quote from a surgeon to highlight a perceived contradiction in the company's marketing claims.", "function": "expose_contradiction", "rawType": "expose_contradiction", "block": null, "metadata": { "slideType": "expose_contradiction", "slideTypeCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-124c-75aa-984a-0a3d0d8fc8df", "version": 1, "description": null }, "function": "expose_contradiction", "functionCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-171f-776f-887c-73edaff4cf9c", "version": 1, "description": null }, "density": "dense", "densityScore": 63, "componentCount": 7, "textChars": 3023, "nDataPoints": 0, "notes": "The slide uses a direct quote from a surgeon to highlight a perceived contradiction in the company's marketing claims.", "elementsJson": [ "paragraph", "quote_block" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:12:30.353+00", "seconds": 3.481, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/187", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-187", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": { "h": 0.05, "w": 0.86, "x": 0.07, "y": 0.52 }, "kind": "callout", "text": "Putting \"very poor quality\" organs on the device, while admitting it doesn't improve them", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": null, "subkind": { "name": "Primary callout", "slug": "primary", "status": "active", "canonId": "019de52c-fbd1-70eb-a9ce-8997f8674c1d", "version": 1, "description": null }, "framework": null }, "subkind": "primary", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:30.353+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "7be83a4c-a28f-4deb-92c5-868ba6ca06e9", "parentComponentId": null }, { "bbox": null, "kind": "callout", "text": "Putting “very poor quality” organs on the device, while admitting it doesn’t improve them", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:14+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a980-4d9294e9b984", "parentComponentId": null }, { "bbox": { "h": 0.35, "w": 0.86, "x": 0.07, "y": 0.14 }, "kind": "paragraph", "text": "Because its highest volume users told us so. One surgeon after the other stated that they use the pump only for the highest-risk, marginal organs – DCD, by definition - while bluntly stating it does nothing to suddenly make those organs less marginal - a striking display of contradiction and intellectual dishonesty: \"we are only using TransMedics for DCD organs...that are very poor quality and, the thing is, if you put them on a machine, you're not going to make a poor-quality organ into a good quality organ...if the organ is poor quality...because the donor was obese or was scarred from drinking, you're not going to reverse those changes...that's a chronic injury...so it's not as beneficial in my mind for those organs.\"", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:30.353+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "07f3f9b6-23e9-4d3c-8f60-15dfb95b2c55", "parentComponentId": null }, { "bbox": { "h": 0.35, "w": 0.86, "x": 0.07, "y": 0.57 }, "kind": "quote", "text": "\"We are only using TransMedics for DCD organs. Donors from cardiac death as opposed to donors from brain death. We're not really convinced that the donors from brain death, the organs get a lot of benefit from being on a TransMedics device because often the ones that you'd like to put on are those that are very poor quality and, the thing is, if you put them on a machine, you're not going to make a poor-quality organ into a good-quality organ. So, if the organ is poor quality because it's fatty because the donor was obese or was scarred from drinking, you're not going to reverse those changes by putting it on a machine... with a marginal organ that's, let's say, fatty or scarred, that's a chronic injury over many, many years. You're not going to reverse that by putting it on a pump. So, it's not as beneficial in my mind for those organs.\" – Transplant surgeon and transplant program director at a leading Northeast academic center", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:30.353+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "56fe3f48-094e-42cb-8b72-abf402ecdbbb", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "“We are only using TransMedics for DCD organs. Donors from cardiac death as opposed to donors from brain death. We’re not really convinced that the donors from brain death, the organs get a lot of benefit from being on a TransMedics device because often the ones that you’d like to put on are those that are very poor quality and, the thing is, if you put them on a machine, you’re not going to make a poor-quality organ into a good-quality organ. So, if the organ is poor quality because it’s fatty because the donor was obese or was scarred from drinking, you’re not going to reverse those changes by putting it on a machine… with a marginal organ that’s, let’s say, fatty or scarred, that’s a chronic injury over many, many years. You’re not going to reverse that by putting it on a pump. So, it’s not as beneficial in my mind for those organs.” — Transplant surgeon and transplant program director at a leading Northeast academic center", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:14+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a980-532fe0c651cc", "parentComponentId": null }, { "bbox": { "h": 0.03, "w": 0.3, "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:30.353+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "8226153c-99a0-402d-9add-fde229908ca5", "parentComponentId": null }, { "bbox": { "h": 0.25, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "title", "text": "How does one know that the entire premise of TransMedics – using a pump to make historically unusable DCD livers usable and open a new category of transplants – is disingenuous?", "attrs": null, "canon": { "kind": { "name": "Title", "slug": "title", "status": "active", "canonId": "019de52c-f7dd-76d9-b848-b1f12bd85cf4", "version": 1, "description": "Slide title or headline." }, "tool": null, "subkind": { "name": "Headline", "slug": "headline", "status": "active", "canonId": "019de52c-fae1-7463-9a7c-d60668eced0d", "version": 1, "description": null }, "framework": null }, "subkind": "headline", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:30.353+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "6534751d-6c34-4489-b303-ac74364acd41", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [ { "matchId": "3e778b56-67fe-4b17-b8d6-12fdd045475d", "evidence": "The slide explicitly frames the surgeon's quote as a 'striking display of contradiction'.", "framework": null, "confidence": 0.9, "extraction": { "at": "2026-05-02 20:12:30.353+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 187, "frameworkName": "expose_contradiction" } ], "arcBeats": [], "loops": [], "locked": true }, { "page": 188, "type": "tension", "title": "The slide uses a Q&A format to expose that the device is being used for high-risk, 'reckless' practices rather than standard clinical indications.", "function": "expose_contradiction", "rawType": "testimonial", "block": null, "metadata": { "slideType": "testimonial", "slideTypeCanon": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52d-0a2d-7782-8a48-7e84df92cc97", "version": 1, "description": null }, "function": "expose_contradiction", "functionCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-171f-776f-887c-73edaff4cf9c", "version": 1, "description": null }, "density": "dense", "densityScore": 51, "componentCount": 6, "textChars": 2139, "nDataPoints": 0, "notes": "The slide uses a Q&A format to expose that the device is being used for high-risk, 'reckless' practices rather than standard clinical indications.", "elementsJson": [ "paragraph", "quote_block", "footnote" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:12:30.037+00", "seconds": 3.054, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/188", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-188", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": { "h": 0.05, "w": 0.86, "x": 0.07, "y": 0.49 }, "kind": "callout", "text": "One of highest volume users: 24 hour pump time; extended warm ischemic time; organs others won’t touch", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": null, "subkind": { "name": "Primary callout", "slug": "primary", "status": "active", "canonId": "019de52c-fbd1-70eb-a9ce-8997f8674c1d", "version": 1, "description": null }, "framework": null }, "subkind": "primary", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:30.037+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "39df8462-71aa-48ac-a329-34841f8f53af", "parentComponentId": null }, { "bbox": null, "kind": "callout", "text": "Similar to every high-volume TransMedics user we interviewed, the center’s utilization of the device is driven entirely by organs that are rejects.", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:14+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a980-7770a14c868b", "parentComponentId": null }, { "bbox": { "h": 0.38, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "paragraph", "text": "A top TransMedics user at a high-volume West Coast academic center chuckled and demurred when we asked if the pump has any benefit on marginal organs, and then proceeded to share how they’re nonetheless “pushing the limits – using organs that no one else would have otherwise used and had not been used before” – such as geriatric donors, organs left on the device “for more than 24 hours,” and “DCD’s that have really extended warm times,” reckless practices that damage the organ and which reputable centers refuse to engage in. Similar to every high-volume TransMedics user we interviewed, the center’s utilization of the device is driven entirely by organs that are rejects: “we’ve done a lot of livers that other people were not willing to consider, and that’s how we’ve been able to power our program forward.”", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:30.037+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "ce60985c-7353-4fe4-a0cc-1c08e0320101", "parentComponentId": null }, { "bbox": { "h": 0.25, "w": 0.86, "x": 0.07, "y": 0.54 }, "kind": "quote", "text": "Q: “You said people are still starting to push the limits of the device. I’ve heard that from some people. What did you mean when you said that?”\nA: “That we push the limits? I was referring to that we were the first center to leave it on the device for more than 24 hours. We’ve done DCD’s that have really extended warm time; older DCDs has kind have been our go-to now. We’ve done a lot of livers that other people were not willing to consider, and that’s how we’ve been able to power our program forward. That’s what I mean by pushing the limits—using organs that no one else would have otherwise ever used and had not been used before.” - Transplant surgeon at a high volume academic center", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:30.037+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "efbaa35e-279f-4607-9382-33aba4fce12e", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "“We’ve done a lot of livers that other people were not willing to consider, and that’s how we’ve been able to power our program forward. That’s what I mean by pushing the limits—using organs that no one else would have otherwise ever used and had not been used before.” — Transplant surgeon at a high volume academic center", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:14+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a980-7a163606cb20", "parentComponentId": null }, { "bbox": { "h": 0.02, "w": 0.3, "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:30.037+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "220c699c-a637-48c3-bfd4-928a7abcefff", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [], "arcBeats": [], "loops": [], "locked": true }, { "page": 189, "type": "tension", "title": "The slide uses a Q&A transcript format to substantiate claims of fraud and kickbacks.", "function": "expose_contradiction", "rawType": "villain_critique", "block": null, "metadata": { "slideType": "villain_critique", "slideTypeCanon": { "name": "Villain critique", "slug": "villain_critique", "status": "active", "canonId": "019de52d-10bc-7136-bf20-09de59d17447", "version": 1, "description": null }, "function": "expose_contradiction", "functionCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-171f-776f-887c-73edaff4cf9c", "version": 1, "description": null }, "density": "dense", "densityScore": 53, "componentCount": 5, "textChars": 3034, "nDataPoints": 1, "notes": "The slide uses a Q&A transcript format to substantiate claims of fraud and kickbacks.", "elementsJson": [ "paragraph", "quote_block", "footnote" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:12:32.082+00", "seconds": 4.674, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/189", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-189", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "He indicated that some centers were happy to jam Medicare for a $90,000 consumable, even when the device was unnecessary, just to use the NOP organ recovery service – a practice our research is prevalent among smaller centers lacking staff and who we believe to be paying for the device as a kickback in exchange for organs steered their way by the NOP program.", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:16+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a983-c4d4558081c7", "parentComponentId": null }, { "bbox": { "h": 0.35, "w": 0.86, "x": 0.07, "y": 0.58 }, "kind": "list", "text": "Ex-procurement surgeon alleged device used for “organs that don’t need to go on the pump”\nA: “The price keeps getting higher and higher to the point that doesn’t make a lot of sense for a lot of people, especially for a transplant program that has 20 or 30 or 40 livers. It has become very, very expensive. However Medicare is going to pay for the cost, and I see some transplant centers are using them on many organs that don’t need to go on the pump.”\nQ: “You’re saying there are a lot of livers that go on the pump, the TransMedics pump, that don’t need to go on the pump?”\nA: “Yeah, some centers are using them as a recovery service as long as somebody else is going to pay this chunk of money.”\nQ: “So, they’re using it as a recovery service even though they don’t really need the—”\nA: “Yes, I’ve seen organs in young patients - I’ve seen very good organs that went on the pump.”\nQ: “So, young patient, very good liver, it’s fine for cold storage, then hospitals are using it just because they want to use the NOP?”\nA: “Just because they want to use the pump or the service for TransMedics.” – Transplant procurement surgeon previously working with TransMedics", "attrs": null, "canon": { "kind": { "name": "List", "slug": "list", "status": "active", "canonId": "019de52c-f94b-779b-a53b-fd4904a5f4d2", "version": 1, "description": "Bullet or numbered list." }, "tool": null, "subkind": { "name": "Bullet list", "slug": "bullet", "status": "active", "canonId": "019de52c-fc98-7169-a083-5cab805076ca", "version": 1, "description": null }, "framework": null }, "subkind": "bullet", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:32.082+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "b27d164c-13d3-4021-8ea5-ebfeac0e9ab9", "parentComponentId": null }, { "bbox": { "h": 0.45, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "paragraph", "text": "A former procurement surgeon who worked with TransMedics told us he resigned because he was forced to engage in various types of inappropriate and unsafe conduct. We redact the duration of his tenure, which was significant: “I was actually one of the top three surgeons...I probably did 100 to 150 livers.” He corroborated the vast scale of the off-label and over-utilization scheme, as he personally observed such organs being retrieved and put on the pump, and stated the pump was unnecessary for most of the organs placed on it – “it has become very, very expensive...centers are using them on so many organs that don’t need to go on the pump...I’ve seen very good organs that went on the pump.” He indicated that some centers were happy to jam Medicare for a $90,000 consumable, even when the device was unnecessary, just to use the NOP organ recovery service - a practice our research is prevalent among smaller centers lacking staff and who we believe to be paying for the device as a kickback in exchange for organs steered their way by the NOP program.", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:32.082+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "69073cc3-e8fd-43c1-bc20-c2e22fa0e761", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "“I was actually one of the top three surgeons...I probably did 100 to 150 livers.” — Former procurement surgeon. “I see some transplant centers are using them on so many organs that don't need to go on the pump.” — Former procurement surgeon. “Yeah, some centers are using them as a recovery service as long as somebody else is going to pay this chunk of money.” — Former procurement surgeon.", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:16+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a983-caeb3cd68125", "parentComponentId": null }, { "bbox": { "h": 0.03, "w": 0.3, "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:32.082+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "d412c3e7-71ea-4479-89da-7cb3f87a48b8", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [ { "matchId": "f2d80d1c-175e-4d84-8041-dfd449d1b085", "evidence": "The slide explicitly alleges kickbacks and Medicare fraud.", "framework": null, "confidence": 0.9, "extraction": { "at": "2026-05-02 20:12:32.082+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 189, "frameworkName": "fraud-exposure" } ], "arcBeats": [], "loops": [], "locked": true }, { "page": 190, "type": "tension", "title": "The slide uses a Q&A format to highlight a specific allegation of unethical pressure to over-utilize a medical device.", "function": "expose_contradiction", "rawType": "expose_contradiction", "block": null, "metadata": { "slideType": "expose_contradiction", "slideTypeCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-124c-75aa-984a-0a3d0d8fc8df", "version": 1, "description": null }, "function": "expose_contradiction", "functionCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-171f-776f-887c-73edaff4cf9c", "version": 1, "description": null }, "density": "balanced", "densityScore": 46, "componentCount": 5, "textChars": 2051, "nDataPoints": 0, "notes": "The slide uses a Q&A format to highlight a specific allegation of unethical pressure to over-utilize a medical device.", "elementsJson": [ "paragraph", "quote_block", "footnote" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:12:30.457+00", "seconds": 3.042, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/190", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-190", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "Ex-surgeon says he resigned as forced to over-utilize the pump; device not needed for “majority of the organs in US”", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:14+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a981-01b1e17fa493", "parentComponentId": null }, { "bbox": { "h": 0.45, "w": 0.86, "x": 0.07, "y": 0.41 }, "kind": "list", "text": "Ex-surgeon says he resigned as forced to over-utilize the pump; device not needed for “majority of the organs in US”\nA: “I left one day when I had been requested to only work with the TransMedics device and not use anything else, so for me, this was a very big red flag...working only with their pump or preventing surgeons from putting livers on ice - to use it on every organ.”\nQ: “You’re saying that they wanted people that would put every organ on a pump. They didn’t want people that would say, ice is okay.”\nA: “Every organ on a pump, no organ on ice.”\nQ: “What percentage of organs would have been fine for ice?\nA: “The majority of organs would be fine...the majority of the organs in the US don’t need to go on a pump.”\nQ: “You said TransMedics is hiring people that will only use the device and that won’t use ice.”\nA: “Yes, who will not use ice.” – Transplant procurement surgeon previously working with TransMedics", "attrs": null, "canon": { "kind": { "name": "List", "slug": "list", "status": "active", "canonId": "019de52c-f94b-779b-a53b-fd4904a5f4d2", "version": 1, "description": "Bullet or numbered list." }, "tool": null, "subkind": { "name": "Bullet list", "slug": "bullet", "status": "active", "canonId": "019de52c-fc98-7169-a083-5cab805076ca", "version": 1, "description": null }, "framework": null }, "subkind": "bullet", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:30.457+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "0fca0ede-30ac-48c4-bcb6-8aaed5eb08cb", "parentComponentId": null }, { "bbox": { "h": 0.25, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "paragraph", "text": "He stated the final straw that led to his resignation was when he was “requested” to place every organ on the pump and to never use ice, this overruling his clinical/professional judgement as the procurement surgeon – when ice is basically free and sufficient for most organs: “I left one day when I had been requested to only work with the TransMedics device and not use anything else...a very big red flag...working only with their pump and preventing surgeons from putting livers on ice...to use it on every organ....no organ on ice...the majority of organs would be fine on ice...the majority of organs in the US don’t need to go on a pump.”", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:30.457+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "04c7b50d-5c10-449f-a815-8d92bf2d260b", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "“I left one day when I had been requested to only work with the TransMedics device and not use anything else...a very big red flag...working only with their pump or preventing surgeons from putting livers on ice - to use it on every organ.” — Transplant procurement surgeon previously working with TransMedics", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:14+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a981-060dc97ff39b", "parentComponentId": null }, { "bbox": { "h": 0.03, "w": 0.3, "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:30.457+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "ec11dec5-8ed5-4000-9506-71ac6ccb5b02", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [], "arcBeats": [], "loops": [], "locked": true }, { "page": 191, "type": "tension", "title": "The slide uses expert testimony to contradict the manufacturer's regulatory compliance claims.", "function": "expose_contradiction", "rawType": "expose_contradiction", "block": null, "metadata": { "slideType": "expose_contradiction", "slideTypeCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-124c-75aa-984a-0a3d0d8fc8df", "version": 1, "description": null }, "function": "expose_contradiction", "functionCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-171f-776f-887c-73edaff4cf9c", "version": 1, "description": null }, "density": "balanced", "densityScore": 36, "componentCount": 6, "textChars": 773, "nDataPoints": 3, "notes": "The slide uses expert testimony to contradict the manufacturer's regulatory compliance claims.", "elementsJson": [ "paragraph", "screenshot", "callout_box" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:12:34.123+00", "seconds": 6.637, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/191", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-191", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "The surgeon stated that the OCS Liver device “is approved for standard anatomy” only – when “the liver has abnormal anatomy, like excessive right hepatic artery...this is off-label.”", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:13+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a980-37fc98b88319", "parentComponentId": null }, { "bbox": { "h": 0.15, "w": 0.86, "x": 0.07, "y": 0.47 }, "kind": "image", "text": "FDA PMA Approval Order Statement, Summary of Safety and Effectiveness Data – Sept 28, 2021", "attrs": null, "canon": { "kind": { "name": "Image", "slug": "image", "status": "active", "canonId": "019de52c-f978-701f-a720-51d029d769e7", "version": 1, "description": "Photo, illustration, screenshot or icon." }, "tool": null, "subkind": { "name": "Screenshot", "slug": "screenshot", "status": "active", "canonId": "019de52c-fd87-7509-8391-3d79fb339379", "version": 1, "description": null }, "framework": null }, "subkind": "screenshot", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:34.123+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "542559d9-9472-4a93-93c5-664ce15b479e", "parentComponentId": null }, { "bbox": { "h": 0.25, "w": 0.86, "x": 0.07, "y": 0.67 }, "kind": "paragraph", "text": "“40-50% at least” of livers beyond labeled age; also used off-label for abnormal anatomy; 1/3 of livers abnormal", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:34.123+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "e1c14fd0-cb2d-4824-83e7-8ecc80a2d9ba", "parentComponentId": null }, { "bbox": { "h": 0.45, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "paragraph", "text": "The surgeon stated that off-label use for organs above the indicated donor age was rampant – “40-50% at least...they will use the device off-label.”", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:34.123+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "f5f23263-c621-430b-870f-b18a18800744", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "“40-50% at least...they will use the device off-label.” — Transplant procurement surgeon previously working with TransMedics", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:13+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a980-3ab0f4305023", "parentComponentId": null }, { "bbox": { "h": 0.03, "w": 0.6, "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts; https://www.accessdata.fda.gov/cdrh_docs/pdf20/P200031B.pdf", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:34.123+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "c570cdef-9a21-4ab1-a2ef-c7c1bef86e84", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [ { "matchId": "a4498887-e10a-4703-b044-7af5315e3168", "evidence": "The slide explicitly contrasts regulatory contraindications with expert testimony of widespread off-label use.", "framework": null, "confidence": 0.9, "extraction": { "at": "2026-05-02 20:12:34.123+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 191, "frameworkName": "fraud-exposure" } ], "arcBeats": [], "loops": [], "locked": true }, { "page": 192, "type": "tension", "title": "The slide uses a Q&A transcript format to build a case against the company's stated compliance.", "function": "expose_contradiction", "rawType": "expose_contradiction", "block": null, "metadata": { "slideType": "expose_contradiction", "slideTypeCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-124c-75aa-984a-0a3d0d8fc8df", "version": 1, "description": null }, "function": "expose_contradiction", "functionCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-171f-776f-887c-73edaff4cf9c", "version": 1, "description": null }, "density": "balanced", "densityScore": 48, "componentCount": 5, "textChars": 2530, "nDataPoints": 0, "notes": "The slide uses a Q&A transcript format to build a case against the company's stated compliance.", "elementsJson": [ "paragraph", "quote_block", "footnote" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:12:32.344+00", "seconds": 4.745, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/192", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-192", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "Off-label use is allegedly openly known and promoted at TransMedics", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:13+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a980-060c2ea0a414", "parentComponentId": null }, { "bbox": { "h": 0.55, "w": 0.86, "x": 0.07, "y": 0.35 }, "kind": "list", "text": "Off-label use is allegedly openly known and promoted at TransMedics\nQ: “Did you ever say this is off-label or would you have gotten fired if you said it?”\nA: “They will tell you that this is off-label; it’s not something hidden.”\nQ: “Who will tell you it’s off-label?”\nA: “Everybody there. They were like, “This is off-label.” It’s abnormal anatomy, using it off-label.”\nQ: “Did the TransMedics staff say you were using it off-label or the surgeon?”\nA: “Yeah-yeah, everybody knows.”\nQ: “Wow”\nA: “Yeah, everybody knows..it’s not something that they’re trying to hide. It’s documented on the liver anatomy page where the OPO has to sign.”\nQ: “I see. Contraindications: “The OCS liver should not be used for livers with moderate or severe traumatic injury, livers with active bleeding, e.g., hematomas, split livers, donor livers with accessory arterial blood supply requiring back-table anastomosis.” Is that what you’re talking about?”\nA: “Yeah, they will use it for back table; they will do that.”\nQ: “That’s what you mean by the arterial abnormality?”\nA: “Yeah, they will use it for abnormal artery.”\nQ: “And that’s what you’re saying is about maybe a third of the cases, just very roughly.”\nA: “Yeah, and I’m aware also that Duke actually used it for split livers as well. I mean, the liver is going to go on the pump as a whole, and then they will take it out and split it afterwards.”\nQ: “So, there’s a lot of off-label usage of this thing.”\nA: “Yeah, it’s not uncommon.” – Transplant procurement surgeon previously working with TransMedics", "attrs": null, "canon": { "kind": { "name": "List", "slug": "list", "status": "active", "canonId": "019de52c-f94b-779b-a53b-fd4904a5f4d2", "version": 1, "description": "Bullet or numbered list." }, "tool": null, "subkind": { "name": "Bullet list", "slug": "bullet", "status": "active", "canonId": "019de52c-fc98-7169-a083-5cab805076ca", "version": 1, "description": null }, "framework": null }, "subkind": "bullet", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:32.344+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "6af97e06-a624-4c55-8bfa-445027113e01", "parentComponentId": null }, { "bbox": { "h": 0.25, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "paragraph", "text": "The surgeon indicated that off-label misuse was promoted and directed by TransMedics in various, overt ways – by definition, as 1) their retrieval surgeons are allegedly, as ex-employees told us, directed to place every organ on the pump, 2) only TransMedics device technicians are allowed to operate the device. The surgeon stated that “they will tell you that this is off-label; it’s not something hidden.” We asked who would tell him it’s off-label: “everybody there...they were like, ‘This is off-label’...it’s abnormal anatomy, using it off-label...yeah, yeah, everybody knows...it’s not something that they’re trying to hide...you can’t...it’s documented on the liver anatomy pages where the OPO has to sign...they will use it for back table; they will do that.”", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:32.344+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "57a8687b-2f4d-4413-9fe2-feb9efc46a32", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "“Yeah, it’s not uncommon.” — Transplant procurement surgeon previously working with TransMedics", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:13+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a980-0959846810d2", "parentComponentId": null }, { "bbox": { "h": 0.03, "w": 0.3, "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:32.344+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "7a0e2835-54ff-4cd3-8f4e-77c3ce48cb47", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [], "arcBeats": [], "loops": [], "locked": true }, { "page": 193, "type": "setup", "title": "This slide serves as a transition or section header for a specific critique point.", "function": "diagnose_problem", "rawType": "section_divider", "block": null, "metadata": { "slideType": "section_divider", "slideTypeCanon": { "name": "Section divider", "slug": "section_divider", "status": "active", "canonId": "019de52d-066a-7402-9554-6ae504999041", "version": 1, "description": null }, "function": "diagnose_problem", "functionCanon": { "name": "Diagnose problem", "slug": "diagnose_problem", "status": "active", "canonId": "019de52d-176d-761f-b608-cf52262d2ab2", "version": 1, "description": null }, "density": "sparse", "densityScore": 14, "componentCount": 3, "textChars": 536, "nDataPoints": 0, "notes": "This slide serves as a transition or section header for a specific critique point.", "elementsJson": [ "paragraph" ], "confidence": 0.9, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:12:29.618+00", "seconds": 1.811, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/193", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-193", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "Part 7. The NOP organ procurement service is “a ticking time bomb” staffed with imported H1B surgeons unlicensed to practice medicine in the US, from high-risk areas like India, Pakistan, and the Middle East; resulting in butchered and lost organs.", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:14+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a980-8e09d8b4bfc0", "parentComponentId": null }, { "bbox": { "h": 0.185, "w": 0.854, "x": 0.073, "y": 0.069 }, "kind": "paragraph", "text": "Part 7. The NOP organ procurement service is “a ticking time bomb” staffed with imported H1B surgeons unlicensed to practice medicine in the US, from high-risk areas like India, Pakistan, and the Middle East; resulting in butchered and lost organs.", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:29.618+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "f41b8406-72fa-49b8-9450-e73752df588d", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "“a ticking time bomb” — Scorpion Capital", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:14+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a980-9214b3e40863", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [], "arcBeats": [], "loops": [], "locked": true }, { "page": 194, "type": "tension", "title": "The slide uses direct quotes from a former executive to highlight perceived operational failures and poor talent quality at TransMedics.", "function": "expose_contradiction", "rawType": "expose_contradiction", "block": null, "metadata": { "slideType": "expose_contradiction", "slideTypeCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-124c-75aa-984a-0a3d0d8fc8df", "version": 1, "description": null }, "function": "expose_contradiction", "functionCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-171f-776f-887c-73edaff4cf9c", "version": 1, "description": null }, "density": "balanced", "densityScore": 29, "componentCount": 5, "textChars": 882, "nDataPoints": 0, "notes": "The slide uses direct quotes from a former executive to highlight perceived operational failures and poor talent quality at TransMedics.", "elementsJson": [ "paragraph", "quote_block", "footnote" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:12:30.502+00", "seconds": 2.649, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/194", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-194", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "it’s an order of magnitude of pain and more to work for TransMedics.", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:14+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a980-e9844444d692", "parentComponentId": null }, { "bbox": { "h": 0.55, "w": 0.86, "x": 0.07, "y": 0.34 }, "kind": "paragraph", "text": "Hiring surgeons no else will hire; recently didn't remove a heart properly and was rejected...", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:30.502+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "9ac1496b-edbf-439d-aa03-e456f975de8e", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "“It’s really hard to get a procurement surgeon. One surgeon that I was talking with said they actually got an organ with not enough aorta to transplant into the patient. So, there wasn’t enough aorta for the poor patient to get the heart, but they rejected the organ. I’ve heard repeatedly that the people that they’ve hired to do the procurements are the surgeons that nobody wants to hire to be a transplant surgeon. These are not the crème de la crème that would be working at Mayo Clinic. These are people who need jobs.” — Former executive in a key reimbursement role", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:14+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a980-edaaf168862a", "parentComponentId": null }, { "bbox": { "h": 0.02, "w": 0.25, "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:30.502+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "104d9614-473a-48ef-9c4a-3f871a392303", "parentComponentId": null }, { "bbox": { "h": 0.22, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "title", "text": "An ex-TransMedics executive expressed shock at the incompetence of its retrieval surgeons...", "attrs": null, "canon": { "kind": { "name": "Title", "slug": "title", "status": "active", "canonId": "019de52c-f7dd-76d9-b848-b1f12bd85cf4", "version": 1, "description": "Slide title or headline." }, "tool": null, "subkind": { "name": "Headline", "slug": "headline", "status": "active", "canonId": "019de52c-fae1-7463-9a7c-d60668eced0d", "version": 1, "description": null }, "framework": null }, "subkind": "headline", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:30.502+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "e1c39ec1-63fc-43f4-a7a3-71e0c5427a4f", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [ { "matchId": "9997c5a4-80fa-4956-96b2-40a1aa000007", "evidence": "The slide contrasts the company's public image with internal claims of hiring unqualified surgeons.", "framework": null, "confidence": 0.9, "extraction": { "at": "2026-05-02 20:12:30.502+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 194, "frameworkName": "expose_contradiction" } ], "arcBeats": [], "loops": [], "locked": true }, { "page": 195, "type": "tension", "title": "The slide uses a combination of summary text and a direct pull-quote with highlighted text to emphasize the severity of the claims.", "function": "name_villain", "rawType": "villain_critique", "block": null, "metadata": { "slideType": "villain_critique", "slideTypeCanon": { "name": "Villain critique", "slug": "villain_critique", "status": "active", "canonId": "019de52d-10bc-7136-bf20-09de59d17447", "version": 1, "description": null }, "function": "name_villain", "functionCanon": { "name": "Name villain", "slug": "name_villain", "status": "active", "canonId": "019de52d-1746-70d6-bc58-5eeaf5865526", "version": 1, "description": null }, "density": "balanced", "densityScore": 35, "componentCount": 5, "textChars": 1186, "nDataPoints": 0, "notes": "The slide uses a combination of summary text and a direct pull-quote with highlighted text to emphasize the severity of the claims.", "elementsJson": [ "paragraph", "quote_block", "footnote" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:12:30.857+00", "seconds": 2.915, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/195", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-195", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "I could tell you seven surgeons who would be, should be excluded from surgery for life because they're very, very brutal - I mean, they have terrible outcomes. They kill more patients than they save, and they still go on to jump around the country at various hospitals.", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:15+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a981-71b076041c45", "parentComponentId": null }, { "bbox": { "h": 0.45, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "paragraph", "text": "The executive provided names of particular NOP surgeons known for repeatedly making critical mistakes, suggesting they end up at TransMedics after running from something...", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:30.857+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "f25a6725-dd06-41e0-8449-991402d0dab3", "parentComponentId": null }, { "bbox": { "h": 0.25, "w": 0.86, "x": 0.07, "y": 0.48 }, "kind": "quote", "text": "Surgeons \"should be excluded from surgery for life\"; \"they kill more patients than they save\"...", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:30.857+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "c29ac586-d18d-4c63-bdc0-bd6bdc34a13d", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "“I could tell you seven surgeons who would be, should be excluded from surgery for life because they're very, very brutal - I mean, they have terrible outcomes. They kill more patients than they save, and they still go on to jump around the country at various hospitals. It happens a lot. She was one of the procurement team surgeons, and I heard specifically about her from this friend who was telling me about the aorta, and he's like, and they hired your favorite person - and I couldn't believe it. Nobody in their right mind would hire her.” — Former executive in a key reimbursement role", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:15+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a981-76d815b7946f", "parentComponentId": null }, { "bbox": { "h": 0.03, "w": 0.3, "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:30.857+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "fdf5113c-ed51-45c0-866b-87d7a430c1a4", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [], "arcBeats": [], "loops": [], "locked": true }, { "page": 196, "type": "tension", "title": "The slide uses direct quotes from a transplant surgeon to validate the claim of incompetence and poor operational performance.", "function": "expose_contradiction", "rawType": "villain_critique", "block": null, "metadata": { "slideType": "villain_critique", "slideTypeCanon": { "name": "Villain critique", "slug": "villain_critique", "status": "active", "canonId": "019de52d-10bc-7136-bf20-09de59d17447", "version": 1, "description": null }, "function": "expose_contradiction", "functionCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-171f-776f-887c-73edaff4cf9c", "version": 1, "description": null }, "density": "overcrowded", "densityScore": 84, "componentCount": 9, "textChars": 3625, "nDataPoints": 1, "notes": "The slide uses direct quotes from a transplant surgeon to validate the claim of incompetence and poor operational performance.", "elementsJson": [ "paragraph", "quote_block", "footnote" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:12:37.206+00", "seconds": 9.041, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/196", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-196", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "A surgeon and “super user” stated that 10% of organs retrieved experience significant mistakes or are unusable because of surgeon error.", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:14+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a980-a20ef5c41923", "parentComponentId": null }, { "bbox": { "h": 0.03, "w": 0.86, "x": 0.07, "y": 0.72 }, "kind": "list", "text": "Taking four hours to retrieve a liver; not capable of retrieving livers properly", "attrs": null, "canon": { "kind": { "name": "List", "slug": "list", "status": "active", "canonId": "019de52c-f94b-779b-a53b-fd4904a5f4d2", "version": 1, "description": "Bullet or numbered list." }, "tool": null, "subkind": { "name": "Bullet list", "slug": "bullet", "status": "active", "canonId": "019de52c-fc98-7169-a083-5cab805076ca", "version": 1, "description": null }, "framework": null }, "subkind": "bullet", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:37.206+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "12511f57-7390-40f9-b2ab-aa56443c5cba", "parentComponentId": null }, { "bbox": { "h": 0.05, "w": 0.86, "x": 0.07, "y": 0.51 }, "kind": "list", "text": "Hiring inferior surgeons who “inadequate skills” lead to loss of organs; 10% of organs lost due to mistakes", "attrs": null, "canon": { "kind": { "name": "List", "slug": "list", "status": "active", "canonId": "019de52c-f94b-779b-a53b-fd4904a5f4d2", "version": 1, "description": "Bullet or numbered list." }, "tool": null, "subkind": { "name": "Bullet list", "slug": "bullet", "status": "active", "canonId": "019de52c-fc98-7169-a083-5cab805076ca", "version": 1, "description": null }, "framework": null }, "subkind": "bullet", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:37.206+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "91c24954-1854-4c95-8219-9f45d6fc3406", "parentComponentId": null }, { "bbox": { "h": 0.25, "w": 0.86, "x": 0.07, "y": 0.23 }, "kind": "paragraph", "text": "A surgeon and “super user” stated that 10% of organs retrieved experience significant mistakes or are unusable because of surgeon error - “they’ve brought on more surgeons that are little bit more questionable skillset...not always the best skilled people...organs have been lost due to inadequate skill of the surgeon...things that are significant.” Organs must be retrieved rapidly as they deteriorate after 30 minutes of warm ischemic time after circulatory death - but TransMedics surgeons are incompetent to the point it “takes four hours from the time of death”; “the most common thing...is it’s taken too long to get the liver from the donor to the pump...ischemic time in between has caused damage....”", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:37.206+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "73d26a90-2b6b-4c00-a616-e007ec5208a0", "parentComponentId": null }, { "bbox": { "h": 0.15, "w": 0.86, "x": 0.07, "y": 0.56 }, "kind": "quote", "text": "“As they’ve expanded, they’ve brought on more surgeons that are a little bit more questionable skillset...they’re building out their program with not always the best-skilled people...mistakes get made when things take too long. I’m sure organs - I know that organs have been lost due to inadequate skills of the surgeon...things that are significant and not just transplant surgeon nit-pickiness, I would say maybe 10% of cases have something significant that should have been done that wasn’t done, or an organ that could have been used probably wasn’t used because the surgeon wasn’t skilled enough - 10% maybe.” - Transplant surgeon at a high-volume academic center", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:37.206+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "4e9e4e73-58d0-421b-a839-f6e608d0d0ae", "parentComponentId": null }, { "bbox": { "h": 0.18, "w": 0.86, "x": 0.07, "y": 0.76 }, "kind": "quote", "text": "Q: “Ten percent is pretty significant.” A: “It is, yeah. The most common thing that’s happened is it’s taken too long to get the liver from the donor to on pump, and I think that ischemic time in between has caused enough damage that the liver, even though it got put on the device, was not good. If it takes four hours from the time of death and the liver gets on the pump, you lost a lot of the benefits of the pump.” Q: “Is that because of the surgeon’s skill, or just because they couldn’t get their crew out there on time?” A: “No-no, surgeon skill. Surgeon skill. Yeah, the donor dies, and they just couldn’t get them or weren’t capable of getting the liver out, getting back tabled, and getting it on the pump on time. Sometimes, there might be a vascular reconstruction...perhaps an artery wasn’t handled well, or something wasn’t tied properly, and then you get some bleeding after the implantation and things like that that are of consequence...” Transplant surgeon at a high-volume academic center", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:37.206+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "5740030e-7bc1-4633-ab57-bc1c60bb5c38", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "“As they’ve expanded, they’ve brought on more surgeons that are a little bit more questionable skillset...they’re building out their program with not always the best-skilled people...mistakes get made when things take too long. I know that organs have been lost due to inadequate skills of the surgeon...things that are significant and not just transplant surgeon nit-pickiness, I would say maybe 10% of cases have something significant that should have been done that wasn’t done, or an organ that could have been used probably wasn’t used because the surgeon wasn’t skilled enough - 10% maybe.” — Transplant surgeon at a high-volume academic center", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:14+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a980-a786f3aba039", "parentComponentId": null }, { "bbox": { "h": 0.02, "w": 0.3, "x": 0.07, "y": 0.96 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:37.206+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "15871f29-ab05-4a45-b9db-27aed7bb3120", "parentComponentId": null }, { "bbox": { "h": 0.15, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "title", "text": "The ex-executive’s surgeon grim assessment is shared by its highest-volume users – making their usage even more troubling, consistent with a perverse incentive whereby organs are steered their way as kickbacks.", "attrs": null, "canon": { "kind": { "name": "Title", "slug": "title", "status": "active", "canonId": "019de52c-f7dd-76d9-b848-b1f12bd85cf4", "version": 1, "description": "Slide title or headline." }, "tool": null, "subkind": { "name": "Headline", "slug": "headline", "status": "active", "canonId": "019de52c-fae1-7463-9a7c-d60668eced0d", "version": 1, "description": null }, "framework": null }, "subkind": "headline", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:37.206+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "3bceb106-6054-48d7-9b4c-9e39e6becfdd", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [], "arcBeats": [], "loops": [], "locked": true }, { "page": 197, "type": "tension", "title": "The slide uses a Q&A format to highlight specific allegations of surgical incompetence and device-related risks.", "function": "expose_contradiction", "rawType": "expose_contradiction", "block": null, "metadata": { "slideType": "expose_contradiction", "slideTypeCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-124c-75aa-984a-0a3d0d8fc8df", "version": 1, "description": null }, "function": "expose_contradiction", "functionCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-171f-776f-887c-73edaff4cf9c", "version": 1, "description": null }, "density": "overcrowded", "densityScore": 76, "componentCount": 9, "textChars": 2273, "nDataPoints": 0, "notes": "The slide uses a Q&A format to highlight specific allegations of surgical incompetence and device-related risks.", "elementsJson": [ "paragraph", "quote_block", "footnote" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:12:31.614+00", "seconds": 3.384, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/197", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-197", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "they literally took the sternal saw and sawed straight through the liver for another center's recipient...yeah, I saw the picture...like, I could do it better than this.", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:14+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a980-bb1a1f8a8457", "parentComponentId": null }, { "bbox": { "h": 0.18, "w": 0.86, "x": 0.07, "y": 0.49 }, "kind": "paragraph", "text": "A: “Something else and device failures. Device failure-wise, it just goes along with what I had mentioned before, how any time that there's even a device failure, any time they could potentially even put the organ at risk or the fact that a recipient will be put under anesthesia waiting for the organ and a device malfunction occurs, and you lose the organ? That's a never event. Or you're going out to—maybe their team is going out, and they're putting the heart on the cannula and bringing it through, but then they damage the lungs for another center, that happens more often than you think. I've heard of—this just happened—I won't name of the center but someone from there reached out to me and said, “Has this ever happened to you guys?” And they literally took the sternal saw, and sawed straight through the liver for another center's recipient.”", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:31.614+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "523ba2fe-e35a-4c9b-8447-13af6c2579eb", "parentComponentId": null }, { "bbox": { "h": 0.07, "w": 0.86, "x": 0.07, "y": 0.69 }, "kind": "paragraph", "text": "A: “Yeah. I saw the pictures. This is like, I could do it better than this. They were procuring for the heart. You see what I'm saying? It's not device malfunction, but it's the experience and expertise of the team and the surgeon who's procuring it.” – Veteran transplant administrator/executive at Massachusetts General Hospital", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:31.614+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "5cbc01f6-acf1-4c9b-862c-ee6980f9a732", "parentComponentId": null }, { "bbox": { "h": 0.28, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "paragraph", "text": "A transplant administrator at Massachusetts General corroborated widespread, catastrophic surgical errors, providing recent examples, such as one where a TransMedics surgeon allegedly sawed another center's liver in half while retrieving a heart...", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:31.614+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "a94cb8e7-8b05-4fbc-8267-883626afe852", "parentComponentId": null }, { "bbox": { "h": 0.05, "w": 0.86, "x": 0.07, "y": 0.44 }, "kind": "paragraph", "text": "Q: “When you say never events shouldn't have occurred. You said adverse events, so you don't lose the organ. What are you referring to? Device failures or something else?”", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:31.614+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "cdf66fb8-4ca8-403e-972f-41819baa7e59", "parentComponentId": null }, { "bbox": { "h": 0.03, "w": 0.86, "x": 0.07, "y": 0.41 }, "kind": "paragraph", "text": "Allegedly sawing livers in two and damaging other organs like lungs; device failures", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:31.614+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "d95ff217-855e-4eb0-a25e-34eaccba181b", "parentComponentId": null }, { "bbox": { "h": 0.02, "w": 0.86, "x": 0.07, "y": 0.67 }, "kind": "paragraph", "text": "Q: “They sawed the liver in two?”", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:31.614+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "de1ccab7-71dc-4278-a647-c9364386bb33", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "“Yeah. I saw the pictures. This is like, I could do it better than this. They were procuring for the heart. You see what I'm saying? It's not device malfunction, but it's the experience and expertise of the team and the surgeon who's procuring it.” — Veteran transplant administrator/executive at Massachusetts General Hospital", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:14+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a980-bdf07451c155", "parentComponentId": null }, { "bbox": { "h": 0.02, "w": 0.3, "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:31.614+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "7ebc10bf-d736-4987-809f-1c7e770b8232", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [], "arcBeats": [], "loops": [], "locked": true }, { "page": 198, "type": "tension", "title": "The slide uses a Q&A format to present a negative expert opinion on TransMedics' clinical quality and hiring standards.", "function": "expose_contradiction", "rawType": "testimonial", "block": null, "metadata": { "slideType": "testimonial", "slideTypeCanon": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52d-0a2d-7782-8a48-7e84df92cc97", "version": 1, "description": null }, "function": "expose_contradiction", "functionCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-171f-776f-887c-73edaff4cf9c", "version": 1, "description": null }, "density": "balanced", "densityScore": 43, "componentCount": 5, "textChars": 1729, "nDataPoints": 0, "notes": "The slide uses a Q&A format to present a negative expert opinion on TransMedics' clinical quality and hiring standards.", "elementsJson": [ "paragraph", "quote_block", "footnote" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:12:31.049+00", "seconds": 2.79, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/198", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-198", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": { "h": 0.03, "w": 0.55, "x": 0.07, "y": 0.38 }, "kind": "callout", "text": "Centers automatically reject any surgeons who worked for TransMedics", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": null, "subkind": { "name": "Primary callout", "slug": "primary", "status": "active", "canonId": "019de52c-fbd1-70eb-a9ce-8997f8674c1d", "version": 1, "description": null }, "framework": null }, "subkind": "primary", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:31.049+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "199f87e8-622d-45e7-a70b-3fa9f01cc766", "parentComponentId": null }, { "bbox": { "h": 0.25, "w": 0.86, "x": 0.07, "y": 0.41 }, "kind": "quote", "text": "Q: “Are there other anecdotes that you’ve heard about, like this liver being sawed into two? Such as lack of surgeon skill and losing the organ?” A: “That’s consistent with what I hear from my other colleagues. As we’re all recruiting for more surgeons, any time that someone at TransMedics applies, I automatically just say no. I had a surgeon we had to let go because of quality issues. TransMedics hired him right up. And so, I also have concerns related to the quality of - and not just their hiring practices but what is their training? What is their ongoing, like continuing medical education? How do they stay abreast of some of the changes that are occurring down the line around new techniques?” – Veteran transplant administrator/executive at Massachusetts General Hospital", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:31.049+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "947e0850-0f64-445f-b348-e31dd84fc273", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "“That’s consistent with what I hear from my other colleagues. As we’re all recruiting for more surgeons, any time that someone at TransMedics applies, I automatically just say no. I had a surgeon we had to let go because of quality issues. TransMedics hired him right up. And so, I also have concerns related to the quality of - and not just their hiring practices but what is their training? What is their ongoing, like continuing medical education? How do they stay abreast of some of the changes that are occurring down the line around new techniques?” — Veteran transplant administrator/executive at Massachusetts General Hospital", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:14+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a980-d6a60a56cccf", "parentComponentId": null }, { "bbox": { "h": 0.02, "w": 0.3, "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:31.049+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "f5c02a3a-e1d8-409e-9b81-ed4f54525cc0", "parentComponentId": null }, { "bbox": { "h": 0.15, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "title", "text": "The Massachusetts General executive stated that they would never hire a surgeon who ever worked there; and noted that TransMedics quickly hired a surgeon they fired due to “quality issues”", "attrs": null, "canon": { "kind": { "name": "Title", "slug": "title", "status": "active", "canonId": "019de52c-f7dd-76d9-b848-b1f12bd85cf4", "version": 1, "description": "Slide title or headline." }, "tool": null, "subkind": { "name": "Headline", "slug": "headline", "status": "active", "canonId": "019de52c-fae1-7463-9a7c-d60668eced0d", "version": 1, "description": null }, "framework": null }, "subkind": "headline", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:31.049+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "09412d2b-b834-4067-991e-6aafd678afa9", "parentComponentId": null } ], "metrics": [], "tools": [ { "tool": { "name": "Anadiplosis", "slug": "anadiplosis", "status": "active", "bestFor": null, "canonId": "019dd956-a0a5-75f9-a98c-7b7d8ee377a1", "version": 1, "bodyDocId": null, "description": "Ending one clause with a word that begins the next", "familyLabel": null, "categoryName": "Loop", "categorySlug": "loop" }, "agent": "Storyteller", "layer": "slide", "agents": [ "Storyteller" ], "matchId": "4ca43971-81a1-4011-b92f-db3ed132bb85", "evidence": "The Massachusetts General executive stated that they would never hire a surgeon who ever worked there; and noted that TransMedics quickly hired a surgeon they fired due to 'quality issues' - This is an example of anadiplosis, where a point is emphasized by repeating it in a different way.", "pageRefs": null, "priority": null, "whenToUse": null, "confidence": 0.7, "extraction": { "at": "2026-07-16 23:10:38.432383+00", "model": "or:meta-llama/llama-4-scout", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 198, "whyItWorks": null, "antipattern": null, "cardinality": null, "narrativePurpose": null } ], "frameworks": [ { "matchId": "add76684-e56a-4382-9028-70bd6d0d97ea", "evidence": "The slide frames TransMedics as an entity with poor quality control and hiring practices.", "framework": null, "confidence": 0.8, "extraction": { "at": "2026-05-02 20:12:31.049+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 198, "frameworkName": "antagonist-introduction" } ], "arcBeats": [], "loops": [], "locked": true }, { "page": 199, "type": "tension", "title": "The slide uses a Q&A format to present qualitative evidence of operational failures and reputational damage.", "function": "name_villain", "rawType": "villain_critique", "block": null, "metadata": { "slideType": "villain_critique", "slideTypeCanon": { "name": "Villain critique", "slug": "villain_critique", "status": "active", "canonId": "019de52d-10bc-7136-bf20-09de59d17447", "version": 1, "description": null }, "function": "name_villain", "functionCanon": { "name": "Name villain", "slug": "name_villain", "status": "active", "canonId": "019de52d-1746-70d6-bc58-5eeaf5865526", "version": 1, "description": null }, "density": "dense", "densityScore": 69, "componentCount": 9, "textChars": 1478, "nDataPoints": 0, "notes": "The slide uses a Q&A format to present qualitative evidence of operational failures and reputational damage.", "elementsJson": [ "paragraph", "quote_block", "footnote" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:12:35.328+00", "seconds": 7.024, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/199", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-199", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "Ex-employees who traveled and worked with TransMedics NOP surgeons in the operating room during organ recoveries provided particularly devastating color about the level of incompetence and mistakes.", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:14+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a981-5888a1cb6c9f", "parentComponentId": null }, { "bbox": { "h": 0.03, "w": 0.86, "x": 0.07, "y": 0.72 }, "kind": "list", "text": "Surgeons allegedly incompetent and FaceTiming for instruction on how prep a liver", "attrs": null, "canon": { "kind": { "name": "List", "slug": "list", "status": "active", "canonId": "019de52c-f94b-779b-a53b-fd4904a5f4d2", "version": 1, "description": "Bullet or numbered list." }, "tool": null, "subkind": { "name": "Bullet list", "slug": "bullet", "status": "active", "canonId": "019de52c-fc98-7169-a083-5cab805076ca", "version": 1, "description": null }, "framework": null }, "subkind": "bullet", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:35.328+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "07a3d648-0d23-40e7-a8e7-9e7bb460c6fa", "parentComponentId": null }, { "bbox": { "h": 0.03, "w": 0.86, "x": 0.07, "y": 0.48 }, "kind": "list", "text": "Hospital staff dismayed when TransMedics NOP surgeons show up; OCS specialist resigned due to discomfort", "attrs": null, "canon": { "kind": { "name": "List", "slug": "list", "status": "active", "canonId": "019de52c-f94b-779b-a53b-fd4904a5f4d2", "version": 1, "description": "Bullet or numbered list." }, "tool": null, "subkind": { "name": "Bullet list", "slug": "bullet", "status": "active", "canonId": "019de52c-fc98-7169-a083-5cab805076ca", "version": 1, "description": null }, "framework": null }, "subkind": "bullet", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:35.328+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "be6cc6a5-8551-4d5b-b71f-ac7101abd51d", "parentComponentId": null }, { "bbox": { "h": 0.08, "w": 0.86, "x": 0.07, "y": 0.3 }, "kind": "paragraph", "text": "The ex-employee stated NOP surgeons were thus viewed with wariness or alarm by hospital staff, and that some were so inexperienced that they had to FaceTime for help...", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:35.328+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "03ce8ee7-f436-40b1-bcc3-a020702dd4f2", "parentComponentId": null }, { "bbox": { "h": 0.08, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "paragraph", "text": "Ex-employees who traveled and worked with TransMedics NOP surgeons in the operating room during organ recoveries provided particularly devastating color about the level of incompetence and mistakes.", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:35.328+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "38529a53-06d0-440f-8740-7b96e51cc28f", "parentComponentId": null }, { "bbox": { "h": 0.15, "w": 0.86, "x": 0.07, "y": 0.15 }, "kind": "paragraph", "text": "A former OCS Specialist with extensive prior experience in operating rooms and proper protocols - the device technicians who transfer, manage, and transport organs on pumps - resigned due to a litany of disturbing practices...", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:35.328+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "5530e887-074f-49dd-b6e0-a5a3f680a906", "parentComponentId": null }, { "bbox": { "h": 0.08, "w": 0.86, "x": 0.07, "y": 0.38 }, "kind": "paragraph", "text": "When we noted that TransMedics seems to have alienated the field, the ex-technician stated “that is pretty accurate...a lot of people, if they know TransMedics is coming to a surgery, they’re like ‘Oh no’...they’re very disappointed...they don’t want to work with the people.”", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:35.328+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "adf517bf-a292-477a-86d5-2ada9f7b993a", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "The way they did things - all of it definitely was not for me...I wasn't super comfortable with things, so I thought it was time to go. — Former TransMedics OCS specialist", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:14+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a981-5eb9bc650198", "parentComponentId": null }, { "bbox": { "h": 0.02, "w": 0.3, "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:35.328+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "dd5bb48d-a150-4de2-af5e-e267a1c566a7", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [], "arcBeats": [], "loops": [], "locked": true }, { "page": 200, "type": "tension", "title": "The slide uses Q&A format to present qualitative evidence of operational failure.", "function": "expose_contradiction", "rawType": "expose_contradiction", "block": null, "metadata": { "slideType": "expose_contradiction", "slideTypeCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-124c-75aa-984a-0a3d0d8fc8df", "version": 1, "description": null }, "function": "expose_contradiction", "functionCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-171f-776f-887c-73edaff4cf9c", "version": 1, "description": null }, "density": "dense", "densityScore": 62, "componentCount": 7, "textChars": 2684, "nDataPoints": 0, "notes": "The slide uses Q&A format to present qualitative evidence of operational failure.", "elementsJson": [ "paragraph", "quote_block" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:12:39.211+00", "seconds": 10.776, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/200", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-200", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "TransMedics surgeons habitually need handholding and \"don't have the skills\"", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:14+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a981-19ceefb68f82", "parentComponentId": null }, { "bbox": { "h": 0.25, "w": 0.86, "x": 0.07, "y": 0.68 }, "kind": "paragraph", "text": "Q: “You mentioned people would realize TransMedics is coming, and they would be disappointed – the receiving transplant center?” A: “Yeah, a lot of the time - I still know people who are working at other hospitals or work for the OPO or something like that. Other surgeons who work for other hospitals on other teams that have to work alongside the surgeons at TransMedics, they would get a little grumpy knowing that they had to work with TransMedics because they didn’t like how they did certain things. Staff didn’t like the way that TransMedics staff or even the surgeons sometimes would come in and interact with the hospital that they were visiting. So, that was an issue. Because a lot of the time, the people who are coming in with TransMedics staff have never been in an operating room before so they don’t really know how to act. So, that was an issue. And then, there were certain times when the OPO had issues with needing to help certain doctors with things that they didn’t feel like they should be responsible for helping them because they were told by TransMedics that the surgeons are supposed to be able to do things independently and they were not able to do things independently.” - Former TransMedics OCS specialist", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:39.211+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "09c38927-c155-49b1-b6b8-8083e7979232", "parentComponentId": null }, { "bbox": { "h": 0.02, "w": 0.5, "x": 0.07, "y": 0.41 }, "kind": "paragraph", "text": "TransMedics surgeons habitually need handholding and “don’t have the skills”", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:39.211+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "0c4696d7-0ccb-4ab6-b333-130c42ecaffc", "parentComponentId": null }, { "bbox": { "h": 0.02, "w": 0.6, "x": 0.07, "y": 0.65 }, "kind": "paragraph", "text": "NOP surgeons and staff are allegedly incompetent and some had never been inside an OR before", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:39.211+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "806eb804-d4f0-4176-af62-013a484c7e52", "parentComponentId": null }, { "bbox": { "h": 0.18, "w": 0.86, "x": 0.07, "y": 0.44 }, "kind": "paragraph", "text": "A: “It was a recurring thing that the OPO was getting mad about having to help certain TransMedics surgeons like, “Every time we’re here, you’re asking for help,” and TransMedics keeps saying, oh no, they don’t need But it’s a recurring thing that they keep asking for help.” Q: “What would TransMedics get help on from the OPO? What did the OPO have to keep helping their surgeons with?” A: “Like an assist in surgery.” Q: “Because the surgeon just wasn’t competent? It seems like something one person could do.” A: “Yeah, this is what I’m talking about when I say that their surgeons could benefit from more experience. With certain docs, it’s a habitual thing where they’re, “I need someone to help me now,” and it’s not for a second. It’s not for five minutes. It’s for an hour....they don’t have the skills. But I can’t officially say that.” - Former TransMedics OCS specialist", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:39.211+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "8e22c14b-b061-4482-9b2f-213c64c6d785", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "“With certain docs, it’s a habitual thing where they’re like, ‘I need someone to help me now,’ and it’s not for a second. It’s not for five minutes. It’s for an hour....they don’t have the skills. But I can’t officially say that.” — Former TransMedics OCS specialist", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:14+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a981-1cd02ddc19f3", "parentComponentId": null }, { "bbox": { "h": 0.02, "w": 0.3, "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:39.211+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "5d0605ec-2b87-48a6-b652-a0b032996f64", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [], "arcBeats": [], "loops": [], "locked": true }, { "page": 201, "type": "tension", "title": "The slide uses a Q&A format to build a narrative of malpractice and dishonesty.", "function": "expose_contradiction", "rawType": "expose_contradiction", "block": null, "metadata": { "slideType": "expose_contradiction", "slideTypeCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-124c-75aa-984a-0a3d0d8fc8df", "version": 1, "description": null }, "function": "expose_contradiction", "functionCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-171f-776f-887c-73edaff4cf9c", "version": 1, "description": null }, "density": "balanced", "densityScore": 33, "componentCount": 6, "textChars": 828, "nDataPoints": 0, "notes": "The slide uses a Q&A format to build a narrative of malpractice and dishonesty.", "elementsJson": [ "paragraph", "quote_block" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:12:31.752+00", "seconds": 2.863, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/201", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-201", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "Some livers were refused on cases I was on because they took too long from incision to getting the liver out or they took too long between cross-clamp and reconstruction.", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:14+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a981-2fa9ea540ac8", "parentComponentId": null }, { "bbox": { "h": 0.3, "w": 0.86, "x": 0.07, "y": 0.35 }, "kind": "list", "text": "Surgeons incompetent with long ischemic times; don't know how to pull out livers; pawning damaged livers to other centers", "attrs": null, "canon": { "kind": { "name": "List", "slug": "list", "status": "active", "canonId": "019de52c-f94b-779b-a53b-fd4904a5f4d2", "version": 1, "description": "Bullet or numbered list." }, "tool": null, "subkind": { "name": "Bullet list", "slug": "bullet", "status": "active", "canonId": "019de52c-fc98-7169-a083-5cab805076ca", "version": 1, "description": null }, "framework": null }, "subkind": "bullet", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:31.752+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "1f099d97-b4be-4ed1-b607-e7a3aadda382", "parentComponentId": null }, { "bbox": { "h": 0.3, "w": 0.86, "x": 0.07, "y": 0.65 }, "kind": "list", "text": "OCS Specialist didn't trust TransMedics to tell the truth to recipient centers about ischemic times and organ quality/damage", "attrs": null, "canon": { "kind": { "name": "List", "slug": "list", "status": "active", "canonId": "019de52c-f94b-779b-a53b-fd4904a5f4d2", "version": 1, "description": "Bullet or numbered list." }, "tool": null, "subkind": { "name": "Bullet list", "slug": "bullet", "status": "active", "canonId": "019de52c-fc98-7169-a083-5cab805076ca", "version": 1, "description": null }, "framework": null }, "subkind": "bullet", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:31.752+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "88aef7f0-a322-4531-8e19-0ffe0a54e6e7", "parentComponentId": null }, { "bbox": { "h": 0.25, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "paragraph", "text": "The ex-OCS Specialist stated that TransMedics surgeons jeopardize and lose organs due to an alleged inability to excise them within the 30 minute limit for warm ischemic time...", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:31.752+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "3053bcf9-2c61-449c-914e-5375110372b3", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "I never really 100% trusted that they were, so I always made sure to get exact times so they could make their own decision based on the numbers. — Former TransMedics OCS specialist", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:14+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a981-337dd59ea7a4", "parentComponentId": null }, { "bbox": { "h": 0.03, "w": 0.3, "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:31.752+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "55e83d24-60d7-45ec-b68e-eefd6a6adc18", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [ { "matchId": "8fbac61a-a29e-4c52-90a2-312ed97b209d", "evidence": "The slide presents testimony to allege systemic malpractice and dishonesty.", "framework": null, "confidence": 0.9, "extraction": { "at": "2026-05-02 20:12:31.752+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 201, "frameworkName": "fraud-exposure" } ], "arcBeats": [], "loops": [], "locked": true }, { "page": 202, "type": "tension", "title": "The slide uses direct quotes to highlight negative perceptions of TransMedics' hiring practices and surgeon qualifications.", "function": "expose_contradiction", "rawType": "testimonial", "block": null, "metadata": { "slideType": "testimonial", "slideTypeCanon": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52d-0a2d-7782-8a48-7e84df92cc97", "version": 1, "description": null }, "function": "expose_contradiction", "functionCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-171f-776f-887c-73edaff4cf9c", "version": 1, "description": null }, "density": "dense", "densityScore": 54, "componentCount": 6, "textChars": 2867, "nDataPoints": 0, "notes": "The slide uses direct quotes to highlight negative perceptions of TransMedics' hiring practices and surgeon qualifications.", "elementsJson": [ "paragraph", "quote_block", "footnote" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:12:32.765+00", "seconds": 3.752, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/202", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-202", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "Often, when you hear that you have a career procurement surgeon, you know that there’s probably something shady in their past, and that’s just the way it is.", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:14+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a981-416ef5543d28", "parentComponentId": null }, { "bbox": { "h": 0.42, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "paragraph", "text": "In addition to OCS Specialists to who worked with TransMedics NOP surgeons in the operating room during organ recoveries, we spoke with organ procurement technicians at other hospitals who were also frequently in OR’s. Their appraisals of TransMedics surgeons were just as scathing as those of ex-employees. We quote a highly experienced retrieval technician, who does runs for a leading academic transplant center and has numerous colleagues inside TransMedics: “I work with TransMedics closely in operating rooms and [I’m] hearing feedback from surgeons at the University of [redacted]”; “it was shocking to find out that surgeons are not licensed...some are problematic because they’ve been through a disciplinary system...and can’t get jobs...often when you hear that you have a career procurement surgeon, you know that there’s probably something shady in their past, and that’s just the way it is.”", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:32.765+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "72192e4a-c5ca-43da-af95-131900d0223a", "parentComponentId": null }, { "bbox": { "h": 0.15, "w": 0.86, "x": 0.07, "y": 0.52 }, "kind": "quote", "text": "Organ procurement technician has extensive interaction with TransMedics teams in operating rooms. \"I work with TransMedics closely in operating rooms. The connections I have to TransMedics are just working with them in the operating room, hearing feedback from surgeons at the University of [redacted] and then my connection to [names redacted] and people that work at TransMedics. I'm on the procurement side. I travel with the surgeons to get the organs and then bring them back.\" – Organ procurement technician at a high-volume Northwest academic transplant center", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:32.765+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "784bf0ec-e847-4bf7-9aff-36ee228f72a6", "parentComponentId": null }, { "bbox": { "h": 0.22, "w": 0.86, "x": 0.07, "y": 0.69 }, "kind": "quote", "text": "\"Shocking to find out that surgeons are not licensed\"; troubling and \"shady\" backgrounds. \"The procurement world is different; it's not regulated like the regular medical community is. I've been doing this for four years and it was shocking to find out that surgeons are not licensed...some are problematic because they’ve been through a disciplinary system in this country and can’t get jobs elsewhere. Often, when you hear that you have a career procurement surgeon, you know that there’s probably something shady in their past, and that’s just the way it is.\" – Organ procurement technician at a high volume Northwest academic transplant center", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:32.765+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "7a83b88b-9d05-49a2-b2c4-47966b45ede3", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "“I work with TransMedics closely in operating rooms and [I’m] hearing feedback from surgeons at the University of [redacted]”; “it was shocking to find out that surgeons are not licensed...some are problematic because they’ve been through a disciplinary system...and can’t get jobs elsewhere. Often, when you hear that you have a career procurement surgeon, you know that there’s probably something shady in their past, and that’s just the way it is.” — Organ procurement technician at a high-volume Northwest academic transplant center", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:14+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a981-45941bb491e2", "parentComponentId": null }, { "bbox": { "h": 0.02, "w": 0.25, "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:32.765+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "c9c85b7e-53aa-48e6-8388-dea0d6e49d03", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [ { "matchId": "fb41b255-a7eb-478d-ab8d-86e1390058c9", "evidence": "The slide frames TransMedics surgeons as problematic/unlicensed to build a negative narrative.", "framework": null, "confidence": 0.8, "extraction": { "at": "2026-05-02 20:12:32.765+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 202, "frameworkName": "antagonist-introduction" } ], "arcBeats": [], "loops": [], "locked": true }, { "page": 203, "type": "tension", "title": "The slide uses a Q&A format to present qualitative feedback from an industry expert.", "function": "expose_contradiction", "rawType": "testimonial", "block": null, "metadata": { "slideType": "testimonial", "slideTypeCanon": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52d-0a2d-7782-8a48-7e84df92cc97", "version": 1, "description": null }, "function": "expose_contradiction", "functionCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-171f-776f-887c-73edaff4cf9c", "version": 1, "description": null }, "density": "dense", "densityScore": 64, "componentCount": 7, "textChars": 3605, "nDataPoints": 0, "notes": "The slide uses a Q&A format to present qualitative feedback from an industry expert.", "elementsJson": [ "paragraph", "quote_block" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:12:33.584+00", "seconds": 4.164, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/203", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-203", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "TransMedics surgeons viewed as a “nightmare to work with”; centers don’t trust organs are handled by qualified surgeons", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:15+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a981-ff45bdb3915c", "parentComponentId": null }, { "bbox": { "h": 0.03, "w": 0.86, "x": 0.07, "y": 0.44 }, "kind": "paragraph", "text": "TransMedics surgeons viewed as a “nightmare to work with”; centers don’t trust organs are handled by qualified surgeons", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:33.584+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "5d1e5a97-56c4-4281-953e-44aa2e7abc4c", "parentComponentId": null }, { "bbox": { "h": 0.18, "w": 0.86, "x": 0.07, "y": 0.47 }, "kind": "paragraph", "text": "Q: “It sounds like you would know a lot about the TransMedics NOP team. What are your overall thoughts? You said feedback from surgeons - what did you observe personally? What have you heard from University of [redacted]?”\nA: “They’re just a nightmare to work with and the general consensus across the board—I work with surgeons all over the country, not just the [redacted]. It’s not a sustainable system. A lot of people don’t think they’re going to be around in a few years. As far as the feedback I’ve heard from the University of [redacted], the discussions are that they don’t trust when the organs come back that they are being handled by somebody who’s qualified, and they’re hesitant to use their services for that reason.” – Organ procurement technician at a high-volume Northwest academic transplant center", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:33.584+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "85361ffe-2f10-48b7-8e8a-3ba3be808a48", "parentComponentId": null }, { "bbox": { "h": 0.28, "w": 0.86, "x": 0.07, "y": 0.66 }, "kind": "paragraph", "text": "Widely despised in the field; “don’t see them being around in a year”\nQ: “Are there any other folks, who have observed some of this behavior on the part of TransMedics, whose name you could provide?”\nA: “The person I know would be [redacted]. I could put you in touch with a lot of people that are just going to say the same thing, “I hate TransMedics.”\nQ: “What sort of people? At other hospitals?”\nA: “The OPOs, hospitals. I had recently had a conversation with the surgeon from our local OPO because I fly with them often for Paragonix. It’s the same thing over and over again, that TransMedics, we don’t see them being here in a year. They’re just so disruptive to the operating room. Just the general consensus that oh, we have to deal with them again?”\nQ: “What other hospitals or surgeons are saying the same thing?\nA: “Often we’ll walk in, and there are teams from Texas, and teams from here and there, and they’re like TransMedics - and the gloom and doom of having to deal with them.” – Organ procurement technician at a high-volume Northwest academic transplant center", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:33.584+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "9120930a-f39f-4556-ba9e-a147641b466a", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "“They’re just a nightmare to work with and the general consensus across the board—I work with surgeons all over the country, not just the [redacted]. It’s not a sustainable system. A lot of people don’t think they’re going to be around in a few years. As far as the feedback I’ve heard from the University of [redacted], the discussions are that they don’t trust when the organs come back that they are being handled by somebody who’s qualified, and they’re hesitant to use their services for that reason.” — Organ procurement technician at a high-volume Northwest academic transplant center", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:15+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a982-00393b683363", "parentComponentId": null }, { "bbox": { "h": 0.02, "w": 0.3, "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:33.584+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "6905331f-2bac-4490-85a9-5b1af566811c", "parentComponentId": null }, { "bbox": { "h": 0.35, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "title", "text": "The organ procurement technician stated that TransMedics surgeons are “just a nightmare to work with and the general consensus across the board – I work with surgeons all over the country....it’s not a sustainable system...a lot of people don’t think they’re going to be around in a few years....the feedback I’ve heard from the University of [redacted]...that they don’t trust when the organs come back that they are being handled by somebody who’s qualified, and they’re hesitant to use the service for that reason”; “I could put you in touch with a lot of people that are just going to say the same thing, ‘I hate TransMedics’...the OPO’s, hospitals...it’s the same thing over and over again, that TransMedics, we don’t see them being here in a year...just the general consensus that oh, we have to deal with them again?”", "attrs": null, "canon": { "kind": { "name": "Title", "slug": "title", "status": "active", "canonId": "019de52c-f7dd-76d9-b848-b1f12bd85cf4", "version": 1, "description": "Slide title or headline." }, "tool": null, "subkind": { "name": "Headline", "slug": "headline", "status": "active", "canonId": "019de52c-fae1-7463-9a7c-d60668eced0d", "version": 1, "description": null }, "framework": null }, "subkind": "headline", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:33.584+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "b9ac1e4d-79d6-4ee6-833a-5b0a0f8be9ee", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [], "arcBeats": [], "loops": [], "locked": true }, { "page": 204, "type": "tension", "title": "The slide uses direct quotes to frame the subject as a villain/incompetent actor. It is a classic 'expert testimony' attack.", "function": "name_villain", "rawType": "villain_critique", "block": null, "metadata": { "slideType": "villain_critique", "slideTypeCanon": { "name": "Villain critique", "slug": "villain_critique", "status": "active", "canonId": "019de52d-10bc-7136-bf20-09de59d17447", "version": 1, "description": null }, "function": "name_villain", "functionCanon": { "name": "Name villain", "slug": "name_villain", "status": "active", "canonId": "019de52d-1746-70d6-bc58-5eeaf5865526", "version": 1, "description": null }, "density": "balanced", "densityScore": 36, "componentCount": 6, "textChars": 980, "nDataPoints": 0, "notes": "The slide uses direct quotes to frame the subject as a villain/incompetent actor. It is a classic 'expert testimony' attack.", "elementsJson": [ "paragraph", "quote_block", "footnote" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:12:32.149+00", "seconds": 2.525, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/204", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-204", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "The organ procurement technician stated TransMedics surgeons are manifestly incompetent, “struggling” in front of other teams in the operating room and that “it’s rare to see one that does it smoothly”.", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:15+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a981-a054e9e48544", "parentComponentId": null }, { "bbox": { "h": 0.45, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "paragraph", "text": "The organ procurement technician stated TransMedics surgeons are manifestly incompetent, “struggling” in front of other teams in the operating room and that “it’s rare to see one that does it smoothly”...", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:32.149+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "ea2b6541-2910-4825-9bdd-c949a0eac54b", "parentComponentId": null }, { "bbox": { "h": 0.18, "w": 0.86, "x": 0.07, "y": 0.75 }, "kind": "quote", "text": "TransMedics surgeons allegedly “struggle”; “compromise the safety”; “we cringe” when TransMedics surgeons walk in...", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:32.149+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "3a217a43-4483-4c1e-a1a7-0c7ea6116a10", "parentComponentId": null }, { "bbox": { "h": 0.18, "w": 0.86, "x": 0.07, "y": 0.55 }, "kind": "quote", "text": "NOP surgeons are inept and struggling; surgical staff wonder “what the hell is happening”; “rare” to see a smooth retrieval...", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:32.149+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "de4deecb-b4f6-481c-9ad9-3e9b7f3e03a7", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "“Each surgeon, the less skilled they are, the more you watch them struggle...sometimes the whole room – you’ve got a room of 10 people that are like, ‘What the hell is happening over there?’” — Organ procurement technician at a high-volume Northwest academic transplant center", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:15+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a981-a653df82c8c8", "parentComponentId": null }, { "bbox": { "h": 0.03, "w": 0.25, "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:32.149+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "88495e5d-bfc2-44ab-8fb3-a61668562b9f", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [ { "matchId": "347caa3e-77f3-4ffa-99dc-3f572e479244", "evidence": "The slide explicitly frames the subject (TransMedics surgeons) as incompetent and a safety risk through negative expert testimony.", "framework": null, "confidence": 0.9, "extraction": { "at": "2026-05-02 20:12:32.149+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 204, "frameworkName": "antagonist-introduction" } ], "arcBeats": [], "loops": [], "locked": true }, { "page": 205, "type": "tension", "title": "The slide uses direct quotes from an organ procurement technician to build a case against NOP surgeons' technical proficiency.", "function": "expose_contradiction", "rawType": "expose_contradiction", "block": null, "metadata": { "slideType": "expose_contradiction", "slideTypeCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-124c-75aa-984a-0a3d0d8fc8df", "version": 1, "description": null }, "function": "expose_contradiction", "functionCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-171f-776f-887c-73edaff4cf9c", "version": 1, "description": null }, "density": "overcrowded", "densityScore": 79, "componentCount": 9, "textChars": 3134, "nDataPoints": 0, "notes": "The slide uses direct quotes from an organ procurement technician to build a case against NOP surgeons' technical proficiency.", "elementsJson": [ "paragraph", "quote_block", "footnote" ], "confidence": 0.95, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:12:33.494+00", "seconds": 3.86, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/205", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-205", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "I often leave, and I’m like, ‘There’s no way they’re going to be able to use that organ’...I feel like they just keep going and going, keep trying and trying and trying...it’s going to be in an operating room with a recipient hours and hours later when the heart function is off.", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:15+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a981-8bf1f8ed5ce5", "parentComponentId": null }, { "bbox": { "h": 0.05, "w": 0.86, "x": 0.07, "y": 0.25 }, "kind": "paragraph", "text": "NOP surgeon incompetence leads to unusable organs, that TransMedics keeps trying to pawn to one center after", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:33.494+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "b38031ab-5b70-427c-87c7-364151c29435", "parentComponentId": null }, { "bbox": { "h": 0.03, "w": 0.86, "x": 0.07, "y": 0.48 }, "kind": "paragraph", "text": "Can’t get any organ procured in time – whether heart, liver or lungs – “just crazy”", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:33.494+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "bf539cca-a344-4ab9-8a1b-edc480cf0baa", "parentComponentId": null }, { "bbox": { "h": 0.15, "w": 0.86, "x": 0.07, "y": 0.3 }, "kind": "quote", "text": "Q: “Have you seen an organ be jeopardized or not be usable because of this incompetence? It sounds like they don’t really care. They’ll just pawn it off to one of their high-volume TransMedics users where they’re just looking for volume for the transplant center.” A: “I often leave, ‘There’s no way they’re going to be able to use that organ’...I feel like they just keep going and going, keep trying and trying and trying...it’s going to be in an operating room with a recipient hours and hours later when the heart function is off.”", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:33.494+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "19b43586-0b2b-4b3f-86d2-d2367c524ee6", "parentComponentId": null }, { "bbox": { "h": 0.18, "w": 0.86, "x": 0.07, "y": 0.52 }, "kind": "quote", "text": "“Typically, the heart is the first thing out the door and it’s on its way. They’re still struggling with the heart. The goal with the heart when you’re not doing TransMedics is to have it packaged and out the door within 20 minutes from cross-clamp. What happens when TransMedics is in the room is we’re out the door packaged with our lungs and gone before they have the heart onto the rig. So, you’re taking a typically 20-minute packaged time, and we’re walking out the door. I often don’t even see them finish because I have to leave before they can get the heart onto the device...and I’m like, “Whoa, that’s just crazy. The heart’s still in the room and the lungs. The kidneys and the liver are already out of the patient. It’s just crazy.”", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:33.494+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "3d02558e-9a79-4b40-bb59-e6baa3e79b12", "parentComponentId": null }, { "bbox": { "h": 0.18, "w": 0.86, "x": 0.07, "y": 0.73 }, "kind": "quote", "text": "NOP surgeons are inept and struggling; surgical staff wonder “what the hell is happening”; “rare” to see a smooth retrieval. “Yeah, they’re on the back table for a long time, so when the organ comes out, and there’s no blood flow,, they bring them onto the back table, and they have to do 35 different things before they can get it on the pump and then start to troubleshoot. They don’t send them help and typically, a surgeon would have at least one to two other people to accomplish what they’re expected to do just with one. So, there’s nobody else scrubbed in—that just doesn’t happen for those kinds of procedures outside of procurement. So, it extends the warm ischemia time on the back table for the organ, which is not ideal.”", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:33.494+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "c25687a1-0e77-4481-b5b4-3aaa15613d44", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "“I often leave, and I’m like, ‘There’s no way they’re going to be able to use that organ’...I feel like they just keep going and going, keep trying and trying and trying...it’s going to be in an operating room with a recipient hours and hours later when the heart function is off.” — Organ procurement technician at a high-volume Northwest academic transplant center", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:15+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a981-8e160c8bc541", "parentComponentId": null }, { "bbox": { "h": 0.03, "w": 0.3, "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:33.494+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "3899c050-6316-4434-bcb9-41f7478e81b6", "parentComponentId": null }, { "bbox": { "h": 0.15, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "title", "text": "The organ procurement technician confirmed the color that NOP surgeons appear to lack the skills to procure organs within the 20-30 minute limit for warm ischemic time, beyond which organs rapidly deteriorate and become unusable", "attrs": null, "canon": { "kind": { "name": "Title", "slug": "title", "status": "active", "canonId": "019de52c-f7dd-76d9-b848-b1f12bd85cf4", "version": 1, "description": "Slide title or headline." }, "tool": null, "subkind": { "name": "Headline", "slug": "headline", "status": "active", "canonId": "019de52c-fae1-7463-9a7c-d60668eced0d", "version": 1, "description": null }, "framework": null }, "subkind": "headline", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:33.494+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "235c7fe0-52e4-428b-9d4f-cf2e5fa66914", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [], "arcBeats": [], "loops": [], "locked": true }, { "page": 206, "type": "tension", "title": "The slide uses direct quotes and interview transcripts to build a case of professional negligence or strategic malpractice.", "function": "expose_contradiction", "rawType": "expose_contradiction", "block": null, "metadata": { "slideType": "expose_contradiction", "slideTypeCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-124c-75aa-984a-0a3d0d8fc8df", "version": 1, "description": null }, "function": "expose_contradiction", "functionCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-171f-776f-887c-73edaff4cf9c", "version": 1, "description": null }, "density": "overcrowded", "densityScore": 88, "componentCount": 11, "textChars": 4122, "nDataPoints": 0, "notes": "The slide uses direct quotes and interview transcripts to build a case of professional negligence or strategic malpractice.", "elementsJson": [ "paragraph", "quote_block" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:12:34.582+00", "seconds": 4.847, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/206", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-206", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "The practice appears to be driven by surgeon ineptitude as well as a strategic decision, as the TransMedics pump seems to require collecting blood from the donor, which is used to then perfuse the organ.", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:15+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a982-45e01ce19dba", "parentComponentId": null }, { "bbox": { "h": 0.03, "w": 0.86, "x": 0.07, "y": 0.51 }, "kind": "paragraph", "text": "Pump allegedly leads NOP surgeons to arrest the heart early to collect blood, jeopardizing other organs", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:34.582+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "734f55ed-b610-49a4-8d2d-dbe194db6aa2", "parentComponentId": null }, { "bbox": { "h": 0.02, "w": 0.86, "x": 0.07, "y": 0.81 }, "kind": "paragraph", "text": "Compromising other organs by arresting heart early", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:34.582+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "a4a8fb15-6d02-4dbe-a84e-238e4c52fcdd", "parentComponentId": null }, { "bbox": { "h": 0.08, "w": 0.86, "x": 0.07, "y": 0.22 }, "kind": "paragraph", "text": "The practice appears to be driven by surgeon ineptitude as well as a strategic decision, as the TransMedics pump seems to require collecting blood from the donor, which is used to then perfuse the organ", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:34.582+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "bae35e7d-bb13-4664-b2ec-bd78b6f4d91c", "parentComponentId": null }, { "bbox": { "h": 0.08, "w": 0.86, "x": 0.07, "y": 0.83 }, "kind": "quote", "text": "“If you’re trying to use the TransMedics heart device and you’re drawing blood, if you do it too quickly, you will stop the heart, and in that moment, every other organ is being compromised. Nothing is receiving oxygen anymore. I’ve heard that they do that, but it doesn’t surprise me.” – Executive at a leading West Coast OPO, longtime industry veteran", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:34.582+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "287b2356-ecca-4a44-b5a3-70029b2621b6", "parentComponentId": null }, { "bbox": { "h": 0.08, "w": 0.86, "x": 0.07, "y": 0.3 }, "kind": "quote", "text": "“if you’re trying to use the TransMedics heart device and you’re drawing blood, if you do it too quickly, you will stop the heart and in that moment, every other organ is being compromised”", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:34.582+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "348c917d-38bd-4304-9ab9-08fe4e850f15", "parentComponentId": null }, { "bbox": { "h": 0.12, "w": 0.86, "x": 0.07, "y": 0.38 }, "kind": "quote", "text": "“they will arrest the heart before the rest of the team is ready...that’s happened multiple times in operating rooms where I was...it’s usually a particular surgeon, in order for them to collect the blood that they put onto their pump....they put the other teams in a tough bind...it’s not ideal for the organs that they’re trying to procure...it consistently pisses off all the team...I don’t know if it’s bad surgical skill...or if it’s strategic.”", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:34.582+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "39e07e62-f903-4e64-84ea-aa49bda1f544", "parentComponentId": null }, { "bbox": { "h": 0.25, "w": 0.86, "x": 0.07, "y": 0.55 }, "kind": "quote", "text": "Q: “You said other surgeons don’t like to work with them and they cringe. You said they compromise safety and do things that only benefit them. Can you elaborate on what you mean there?” A: “They will arrest the heart before the rest of the team is ready. That’s happened multiple times in operating rooms where I was. And then, it’s usually a particular surgeon. In order for them to collect the blood that they put onto their pump, they put the other teams in a tough bind because it’ll arrest early and it’ll start draining the blood, and then everybody else is kind of sitting around, which is not ideal. And sometimes, that doesn’t always go smoothly. They don’t always get the amount of blood they need, or they need more time to get the blood they need, and it kind of puts everybody else in a pinch because it’s not ideal for the organs that they’re trying to procure. It consistently pisses off all the teams. For some reason, there are certain TransMedics surgeons that will do that before everybody is in place and ready to go on a regular basis. I don’t know if it’s bad surgical skill, which is a possibility. Or if it’s strategic. It just consistently happens.” – Organ procurement technician at a high volume Northwest academic transplant center", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:34.582+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "9318194d-b9cc-4dc5-a434-299dca4a524e", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "They will arrest the heart before the rest of the team is ready. That’s happened multiple times in operating rooms where I was. And then, it’s usually a particular surgeon. In order for them to collect the blood that they put onto their pump, they put the other teams in a tough bind because it’ll arrest early and it’ll start draining the blood, and then everybody else is kind of sitting around, which is not ideal. And sometimes, that doesn’t always go smoothly. They don’t always get the amount of blood they need, or they need more time to get the blood they need, and it kind of puts everybody else in a pinch because it’s not ideal for the organs that they’re trying to procure. It consistently pisses off all the teams. For some reason, there are certain TransMedics surgeons that will do that before everybody is in place and ready to go on a regular basis. I don’t know if it’s bad surgical skill, which is a possibility. Or if it’s strategic. It just consistently happens. — Organ procurement technician at a high volume Northwest academic transplant center", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:15+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a982-4ab538850644", "parentComponentId": null }, { "bbox": { "h": 0.02, "w": 0.3, "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:34.582+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "fc84ac59-e841-4f48-9e6e-d5be7eb85655", "parentComponentId": null }, { "bbox": { "h": 0.15, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "title", "text": "The organ procurement technician alleged conduct by TransMedics surgeons, during heart procurements - arresting the heart prematurely - that jeopardizes the retrieval of every other organ.", "attrs": null, "canon": { "kind": { "name": "Title", "slug": "title", "status": "active", "canonId": "019de52c-f7dd-76d9-b848-b1f12bd85cf4", "version": 1, "description": "Slide title or headline." }, "tool": null, "subkind": { "name": "Headline", "slug": "headline", "status": "active", "canonId": "019de52c-fae1-7463-9a7c-d60668eced0d", "version": 1, "description": null }, "framework": null }, "subkind": "headline", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:34.582+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "97462e7c-a380-43fe-8920-76b184784445", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [], "arcBeats": [], "loops": [], "locked": true }, { "page": 207, "type": "tension", "title": "The slide uses direct quotes to frame TransMedics' surgical practices as a liability and a regression in quality standards.", "function": "expose_contradiction", "rawType": "ceo_quote", "block": null, "metadata": { "slideType": "ceo_quote", "slideTypeCanon": { "name": "CEO quote", "slug": "ceo_quote", "status": "active", "canonId": "019de52d-09b6-71c8-93a5-f90a9772a8fa", "version": 1, "description": null }, "function": "expose_contradiction", "functionCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-171f-776f-887c-73edaff4cf9c", "version": 1, "description": null }, "density": "dense", "densityScore": 52, "componentCount": 7, "textChars": 1354, "nDataPoints": 0, "notes": "The slide uses direct quotes to frame TransMedics' surgical practices as a liability and a regression in quality standards.", "elementsJson": [ "paragraph", "quote_block", "footnote" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:12:38.408+00", "seconds": 8.648, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/207", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-207", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "It’s a ticking time bomb. It’s a ticking time bomb. They’re cutting corners. Wait until somebody finds out.", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:15+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a981-bbbd33eda30d", "parentComponentId": null }, { "bbox": { "h": 0.12, "w": 0.86, "x": 0.07, "y": 0.22 }, "kind": "paragraph", "text": "The executive bemoaned that procurement teams working for reputable transplant centers would “get pissed” if a fellow was sent to a retrieval versus an attending – despite fellows being MD’s with “5 years of surgical residencies and 2 years of fellowship” – and that “now it’s regressed so far” with TransMedics surgeons who are not “licensed to practice in the United States.”", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:38.408+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "93dc3268-53ef-4d81-8a26-b8f0e0eab8af", "parentComponentId": null }, { "bbox": { "h": 0.25, "w": 0.86, "x": 0.07, "y": 0.37 }, "kind": "quote", "text": "NOP surgeons “couldn’t hack it” elsewhere; “ticking time bomb”... [full quote text]", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:38.408+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "245017ee-5a84-4a06-993c-1795883513fe", "parentComponentId": null }, { "bbox": { "h": 0.25, "w": 0.86, "x": 0.07, "y": 0.63 }, "kind": "quote", "text": "“Regressed so far” with quality of TransMedics surgeons vs use of fellows and attending surgeons previously... [full quote text]", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:38.408+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "c0425e2b-389a-4807-90d7-3d1498a76456", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "“What they do is they get these foreign-trained physicians to do recoveries. They haven’t gone through the process of being licensed to practice in the United States, and that’s exactly what it is. If you’re a recovery surgeon, you’re either in the twilight of your career and you’re just like the hell with patients, or you’re somebody who couldn’t hack it.” — CEO of a major OPO (Organ Procurement Organization), longtime industry executive", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:15+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a981-bd1b48297532", "parentComponentId": null }, { "bbox": { "h": 0.03, "w": 0.3, "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:38.408+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "afc1b56a-30ea-40c2-b958-737156abf062", "parentComponentId": null }, { "bbox": { "h": 0.15, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "title", "text": "The CEO of a major OPO called the use of unlicensed “foreign-trained physicians” a “ticking time bomb...they’re cutting corners...wait until somebody finds out.”", "attrs": null, "canon": { "kind": { "name": "Title", "slug": "title", "status": "active", "canonId": "019de52c-f7dd-76d9-b848-b1f12bd85cf4", "version": 1, "description": "Slide title or headline." }, "tool": null, "subkind": { "name": "Headline", "slug": "headline", "status": "active", "canonId": "019de52c-fae1-7463-9a7c-d60668eced0d", "version": 1, "description": null }, "framework": null }, "subkind": "headline", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:38.408+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "3ba1eba1-ff0f-4c2f-80cb-b654f5ceb4d7", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [ { "matchId": "65890d80-6e59-4840-bb3b-33da44903c8d", "evidence": "Uses direct executive testimony to highlight perceived quality regression and safety risks.", "framework": null, "confidence": 0.9, "extraction": { "at": "2026-05-02 20:12:38.408+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 207, "frameworkName": "ceo-quote-contradiction" } ], "arcBeats": [], "loops": [], "locked": true }, { "page": 208, "type": "tension", "title": "The slide uses a 'villain' narrative structure to cast doubt on the company's operational standards.", "function": "expose_contradiction", "rawType": "expose_contradiction", "block": null, "metadata": { "slideType": "expose_contradiction", "slideTypeCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-124c-75aa-984a-0a3d0d8fc8df", "version": 1, "description": null }, "function": "expose_contradiction", "functionCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-171f-776f-887c-73edaff4cf9c", "version": 1, "description": null }, "density": "dense", "densityScore": 58, "componentCount": 7, "textChars": 1815, "nDataPoints": 0, "notes": "The slide uses a 'villain' narrative structure to cast doubt on the company's operational standards.", "elementsJson": [ "paragraph", "quote_block" ], "confidence": 0.95, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:12:33.142+00", "seconds": 3.154, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/208", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-208", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "most TransMedics customers appear clueless and told us they just assume they’re licensed.", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:15+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a981-eab1163bdbd4", "parentComponentId": null }, { "bbox": { "h": 0.45, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "paragraph", "text": "While a handful of transplant centers are aware that TransMedics appears to use surgeons who are unlicensed to practice medicine in the US, and therefore avoid its device – “that’s part of why we don’t trust their surgeons” – most TransMedics customers appear clueless and told us they just assume they’re licensed.", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:33.142+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "54c19256-a73b-4b8f-8e51-a9ee22763ef8", "parentComponentId": null }, { "bbox": { "h": 0.12, "w": 0.86, "x": 0.07, "y": 0.51 }, "kind": "quote", "text": "Transplant surgeon won't use NOP – “I don't trust their surgeons”... “I don't trust their surgeons... You don't have your top-tier surgeons working for TransMedics.”", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:33.142+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "d91a5ca9-5bdd-4a6a-a94e-c7326cd20a51", "parentComponentId": null }, { "bbox": { "h": 0.12, "w": 0.86, "x": 0.07, "y": 0.79 }, "kind": "quote", "text": "High volume user unaware that TransMedics surgeons are licensed; thinks requirements will become more stringent... “you have to graduate from a transplant fellowship... you have to be credentialed as a transplant surgeon.”", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:33.142+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "f6fdabc8-7663-4d0c-87d9-5a0f9972fd3b", "parentComponentId": null }, { "bbox": { "h": 0.12, "w": 0.86, "x": 0.07, "y": 0.65 }, "kind": "quote", "text": "High volume TransMedics user ignorant and thinks NOP surgeons are licensed to practice surgery... “the surgeons that may be for procuring organs - by the way, just to be clear, if you're procuring an organ in an OR in the continental US, there's no way you're not licensed to practice medicine and surgery.”", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:33.142+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "f72f4678-cf74-4cc5-9e4e-d81cc0659140", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "“that’s part of why we don’t use it...I don’t trust their surgeons...you don’t have top-tier surgeons working for TransMedics” — Cardiac transplant surgeon at a major Midwest academic center; “if you’re procuring an organ in an OR in the continental US, there’s no way you’re not licensed to practice medicine and surgery.” — Transplant hepatologist and director of the liver program at a Midwest academic center; “you have to be credentialed by the hospital as a transplant surgeon...no one’s operating...without an MD, general surgeon residency...and a fellowship.” — Transplant surgeon and surgical director at a high-volume academic center in the western US", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:15+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a981-ef85f1f12379", "parentComponentId": null }, { "bbox": { "h": 0.03, "w": 0.3, "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:33.142+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "9a12ec4c-6196-4f16-96c1-ca014c0f3707", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [ { "matchId": "eb4c122a-b16b-4423-811c-18b956fcebd8", "evidence": "The slide explicitly attempts to expose a gap between company practice and customer perception regarding surgeon licensing.", "framework": null, "confidence": 0.9, "extraction": { "at": "2026-05-02 20:12:33.142+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 208, "frameworkName": "fraud-exposure" } ], "arcBeats": [], "loops": [], "locked": true }, { "page": 209, "type": "tension", "title": "The slide uses direct quotes to expose a gap between customer perception and the company's actual practices.", "function": "expose_contradiction", "rawType": "testimonial", "block": null, "metadata": { "slideType": "testimonial", "slideTypeCanon": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52d-0a2d-7782-8a48-7e84df92cc97", "version": 1, "description": null }, "function": "expose_contradiction", "functionCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-171f-776f-887c-73edaff4cf9c", "version": 1, "description": null }, "density": "dense", "densityScore": 63, "componentCount": 7, "textChars": 3038, "nDataPoints": 0, "notes": "The slide uses direct quotes to expose a gap between customer perception and the company's actual practices.", "elementsJson": [ "paragraph", "quote_block", "footnote" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:12:33.984+00", "seconds": 3.696, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/209", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-209", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "The OPO CEO appears prescient - “it’s a ticking time bomb...wait til somebody finds out” - judging by the reactions we observed.", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:15+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a982-7efe3640665e", "parentComponentId": null }, { "bbox": { "h": 0.25, "w": 0.86, "x": 0.07, "y": 0.52 }, "kind": "list", "text": "Transplant centers would be “shocked” to find out TransMedics surgeons are unlicensed and “probably put a stop to it”. Q: “Would a medical director ever hire a procurement surgeon that didn’t have a California medical license?” A: “No. We have a new transplant center that might open up in Reno, and the person they hired from the New York team, he’s only credentialed to do kidneys. He’s not credentialed to do abdomen and other organs and UCSF and Stanford said until he gets credentialed, he’s not coming out on cases.” Q: “Yet, those same hospitals are forced to use a TransMedics NOP with a non-credentialed surgeon.” A: “If they knew that, they’re either accepting that risk or they’re not aware of it...yeah, they’d be shocked. They would probably put a stop to it. I would think they’d have to because I don’t know if they absorb the risk of a poor recovery or surgical mistakes. The OPO wouldn’t.” – C-level officer of one of the largest OPO’s (organ procurement organizations) in the country", "attrs": null, "canon": { "kind": { "name": "List", "slug": "list", "status": "active", "canonId": "019de52c-f94b-779b-a53b-fd4904a5f4d2", "version": 1, "description": "Bullet or numbered list." }, "tool": null, "subkind": { "name": "Bullet list", "slug": "bullet", "status": "active", "canonId": "019de52c-fc98-7169-a083-5cab805076ca", "version": 1, "description": null }, "framework": null }, "subkind": "bullet", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:33.984+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "52b66772-cbcf-4aa6-bcdd-759a08b02c7c", "parentComponentId": null }, { "bbox": { "h": 0.15, "w": 0.86, "x": 0.07, "y": 0.35 }, "kind": "list", "text": "High volume user unaware that TransMedics surgeons are licensed; thinks requirements will become more stringent. Q: “The TransMedics people, a lot of their surgeons are not licensed in the US. They’re importing them from Pakistan, India, and stuff like that. “ A: “Oh really? I didn’t know that.” – Transplant surgeon and surgical director at a high-volume academic center in the western US", "attrs": null, "canon": { "kind": { "name": "List", "slug": "list", "status": "active", "canonId": "019de52c-f94b-779b-a53b-fd4904a5f4d2", "version": 1, "description": "Bullet or numbered list." }, "tool": null, "subkind": { "name": "Bullet list", "slug": "bullet", "status": "active", "canonId": "019de52c-fc98-7169-a083-5cab805076ca", "version": 1, "description": null }, "framework": null }, "subkind": "bullet", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:33.984+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "babeb985-c649-4df3-b3f9-1e62a44c101d", "parentComponentId": null }, { "bbox": { "h": 0.12, "w": 0.86, "x": 0.07, "y": 0.79 }, "kind": "list", "text": "MGH appears to have no idea NOP surgeons are not licensed. “Their surgical procurement is the black box that I’ve never known anything about. Here I am thinking a national organ program could be surgeons from accredited centers who are hired guns for the company. But that’s such a simplistic assumption.” – Transplant hepatologist Massachusetts General Hospital", "attrs": null, "canon": { "kind": { "name": "List", "slug": "list", "status": "active", "canonId": "019de52c-f94b-779b-a53b-fd4904a5f4d2", "version": 1, "description": "Bullet or numbered list." }, "tool": null, "subkind": { "name": "Bullet list", "slug": "bullet", "status": "active", "canonId": "019de52c-fc98-7169-a083-5cab805076ca", "version": 1, "description": null }, "framework": null }, "subkind": "bullet", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:33.984+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "ec5f0389-b0ec-4164-a1fe-abefccb37bc5", "parentComponentId": null }, { "bbox": { "h": 0.25, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "paragraph", "text": "When we queried customers about TransMedics alleged use of unlicensed surgeons, particularly high-volume users, they were stunned and/or embarrassed: “Oh really? I didn’t know that.”. The OPO CEO appears prescient - “it’s a ticking time bomb...wait til somebody finds out” – judging by the reactions we observed. A transplant physician in a leadership role at Massachusetts General appeared shaken and then admitted that “their surgical procurement is the black box that I’ve never known anything about...here I am thinking a national organ program could be surgeons from accredited programs who are hired guns for the company...but that’s such a simplistic assumption.”", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:33.984+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "afe163fc-fdf5-4133-a8f1-803c5d91573b", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "“Oh really? I didn’t know that.” — Transplant surgeon and surgical director at a high-volume academic center in the western US; “Their surgical procurement is the black box that I’ve never known anything about. Here I am thinking a national organ program could be surgeons from accredited centers who are hired guns for the company. But that’s such a simplistic assumption.” — Transplant hepatologist Massachusetts General Hospital", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:15+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a982-8212455cd9f6", "parentComponentId": null }, { "bbox": { "h": 0.02, "w": 0.3, "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:33.984+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "99118dc3-9683-4e00-a321-e19d40ce95ce", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [], "arcBeats": [], "loops": [], "locked": true }, { "page": 210, "type": "tension", "title": "The slide uses direct quotes from a former employee to build a case against the company's operational integrity.", "function": "expose_contradiction", "rawType": "villain_critique", "block": null, "metadata": { "slideType": "villain_critique", "slideTypeCanon": { "name": "Villain critique", "slug": "villain_critique", "status": "active", "canonId": "019de52d-10bc-7136-bf20-09de59d17447", "version": 1, "description": null }, "function": "expose_contradiction", "functionCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-171f-776f-887c-73edaff4cf9c", "version": 1, "description": null }, "density": "dense", "densityScore": 58, "componentCount": 6, "textChars": 2860, "nDataPoints": 1, "notes": "The slide uses direct quotes from a former employee to build a case against the company's operational integrity.", "elementsJson": [ "paragraph", "quote_block", "footnote" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:12:33.935+00", "seconds": 3.244, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/210", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-210", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "He alleged that TransMedics improperly credentialed them as procurement technicians in collusion with the local OPO - New England Donor Services, run by a controversial CEO and the subject of various investigative pieces, and who we heard is close to TransMedics' CEO.", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:15+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a981-d0834e273f3a", "parentComponentId": null }, { "bbox": { "h": 0.45, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "paragraph", "text": "A former procurement surgeon who worked with TransMedics told us he resigned because he was forced to engage in inappropriate and unsafe conduct. We redacted the duration of his tenure, which was significant: “I was actually one of the top three surgeons...I probably did 100 to 150 livers.” He stated “they hired somebody from England” who “brought quite a large number” of surgeons who “were never trained in the United States...they’re not licensed to practice medicine” - referring to Magdy Attia, “Chief of OCS Liver Transplant program at TransMedics.” He alleged that TransMedics improperly credentialed them as procurement technicians in collusion with the local OPO – New England Donor Services, run by a controversial CEO and the subject of various investigative pieces, and who we heard is close to TransMedics’ CEO: “they managed to give them an authorization to recover organs through their local OPO in Boston...it’s amazing because those surgeons are not licensed by any licensing state or any licensing entity in the US but they still managed to work because they gave them the authorization....”", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:33.935+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "de626a76-417a-4e7d-a4ed-5027367fb6d7", "parentComponentId": null }, { "bbox": { "h": 0.18, "w": 0.86, "x": 0.07, "y": 0.72 }, "kind": "quote", "text": "Surgeons not licensed to practice in US, allegedly certified improperly through the local OPO. “They hired somebody from England. He brought quite a large number of surgeons from England to recover...however, they were never trained in the United States...they’re not licensed to practice medicine, but they managed to give them an authorization to recover organs through their local OPO in Boston. They have a very good relationship with them. It’s amazing because those surgeons are not licensed by any licensing state or any licensing entity in the US but they still managed to work because they gave them authorization through the OPO in Boston...” – Transplant procurement surgeon previously working with TransMedics", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:33.935+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "122eeb90-0e81-4b00-ac58-00a18bd7303d", "parentComponentId": null }, { "bbox": { "h": 0.1, "w": 0.86, "x": 0.07, "y": 0.62 }, "kind": "quote", "text": "Ex-procurement surgeon procured 100-150 livers for TransMedics. “I did work with them for a good [redacted timeframe]. I was actually one of the top three surgeons who performed liver procurements for them. I probably did 100 to 150 livers.” – Transplant procurement surgeon previously working with TransMedics", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:33.935+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "d1e95f6b-35cc-4aef-b271-54f27c5cad77", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "\"I was actually one of the top three surgeons...I probably did 100 to 150 livers.\" — Transplant procurement surgeon previously working with TransMedics. \"They hired somebody from England\" who \"brought quite a large number\" of surgeons who \"were never trained in the United States...they’re not licensed to practice medicine\" — Transplant procurement surgeon previously working with TransMedics.", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:15+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a981-d7a88ecab35a", "parentComponentId": null }, { "bbox": { "h": 0.02, "w": 0.3, "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:33.935+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "45c55e19-4f08-4662-94b0-0dbf073115f6", "parentComponentId": null } ], "metrics": [], "tools": [ { "tool": { "name": "Villain slide", "slug": "villain-slide", "status": "active", "bestFor": "In activist decks where the personality matters", "canonId": "019dd9e1-518c-7404-976a-5be5a517b659", "version": 1, "bodyDocId": null, "description": "A dedicated slide presenting the named villain visually", "familyLabel": null, "categoryName": null, "categorySlug": null }, "agent": null, "layer": "slide", "agents": null, "matchId": "1bb5e0d9-3f0d-48ba-bdc6-edc6ecd83c0d", "evidence": "The slide presents a critical view of TransMedics, highlighting a surgeon's resignation due to forced engagement in inappropriate and unsafe conduct.", "pageRefs": null, "priority": null, "whenToUse": "In activist decks where the personality matters", "confidence": 0.9, "extraction": { "at": "2026-07-16 23:10:37.243307+00", "model": "or:meta-llama/llama-4-scout", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 210, "whyItWorks": "Makes the antagonist concrete", "antipattern": null, "cardinality": null, "narrativePurpose": null } ], "frameworks": [], "arcBeats": [], "loops": [], "locked": true }, { "page": 211, "type": "tension", "title": "The slide uses a Q&A format to highlight the 'unusual' nature of the credentialing process, followed by a direct citation of the AOPO manual to suggest a violat", "function": "expose_contradiction", "rawType": "expose_contradiction", "block": null, "metadata": { "slideType": "expose_contradiction", "slideTypeCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-124c-75aa-984a-0a3d0d8fc8df", "version": 1, "description": null }, "function": "expose_contradiction", "functionCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-171f-776f-887c-73edaff4cf9c", "version": 1, "description": null }, "density": "balanced", "densityScore": 29, "componentCount": 6, "textChars": 675, "nDataPoints": 0, "notes": "The slide uses a Q&A format to highlight the 'unusual' nature of the credentialing process, followed by a direct citation of the AOPO manual to suggest a violation of standard protocols.", "elementsJson": [ "paragraph", "data_table" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:12:33.403+00", "seconds": 2.596, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/211", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-211", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "I'm not aware of anybody else who can do that.", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:15+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a982-11d10a3b68f7", "parentComponentId": null }, { "bbox": { "h": 0.25, "w": 0.86, "x": 0.07, "y": 0.41 }, "kind": "paragraph", "text": "Allegedly obtained ACIN numbers thorough New England OPO; highly unusual...", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:33.403+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "97495c47-44ea-4f8d-9143-de05239a0c24", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "“When [redacted] asked, he said all of them have the ACIN through the OPO, through the New England OPO. How did he do that? I don't know.” — Transplant procurement surgeon previously working with TransMedics", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:15+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a982-1700fd982f29", "parentComponentId": null }, { "bbox": { "h": 0.03, "w": 0.75, "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts; https://aopo.org/wp-content/uploads/AOPO-Standards-Interpretive-Guidlines_January-2020_Final.pdf;", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:33.403+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "20ea7e0a-26cb-4d47-bae8-0937c1a3f1d5", "parentComponentId": null }, { "bbox": { "h": 0.22, "w": 0.86, "x": 0.07, "y": 0.68 }, "kind": "table", "text": "AOPO Standards and Interpretative Guidelines, Manual, Jan 2020", "attrs": null, "canon": { "kind": { "name": "Table", "slug": "table", "status": "active", "canonId": "019de52c-f9c8-7148-8119-eaac9594cd28", "version": 1, "description": "Tabular data layout." }, "tool": null, "subkind": { "name": "Data table", "slug": "data", "status": "active", "canonId": "019de52d-02d5-75b8-8abf-88e92bf63569", "version": 1, "description": null }, "framework": null }, "subkind": "data", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:33.403+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "f1c4d1da-5714-4619-baaf-ca7cb749b8cd", "parentComponentId": null }, { "bbox": { "h": 0.12, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "title", "text": "The ex-TransMedics surgeon alleged that the credentialing/licensing scheme involved the granting of “ACIN numbers” through the OPO", "attrs": null, "canon": { "kind": { "name": "Title", "slug": "title", "status": "active", "canonId": "019de52c-f7dd-76d9-b848-b1f12bd85cf4", "version": 1, "description": "Slide title or headline." }, "tool": null, "subkind": { "name": "Headline", "slug": "headline", "status": "active", "canonId": "019de52c-fae1-7463-9a7c-d60668eced0d", "version": 1, "description": null }, "framework": null }, "subkind": "headline", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:33.403+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "914330b3-7e81-43b7-bf5d-a2dc25a74030", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [ { "matchId": "85aa4352-a365-4ba2-a185-b754ce2175da", "evidence": "The slide explicitly contrasts expert testimony with official industry standards to allege misconduct.", "framework": null, "confidence": 0.9, "extraction": { "at": "2026-05-02 20:12:33.403+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 211, "frameworkName": "fraud-exposure" } ], "arcBeats": [], "loops": [], "locked": true }, { "page": 212, "type": "tension", "title": "The slide uses a Q&A format to substantiate claims of regulatory circumvention.", "function": "expose_contradiction", "rawType": "expose_contradiction", "block": null, "metadata": { "slideType": "expose_contradiction", "slideTypeCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-124c-75aa-984a-0a3d0d8fc8df", "version": 1, "description": null }, "function": "expose_contradiction", "functionCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-171f-776f-887c-73edaff4cf9c", "version": 1, "description": null }, "density": "dense", "densityScore": 56, "componentCount": 6, "textChars": 3691, "nDataPoints": 0, "notes": "The slide uses a Q&A format to substantiate claims of regulatory circumvention.", "elementsJson": [ "paragraph", "quote_block" ], "confidence": 0.95, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:12:34.275+00", "seconds": 3.465, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/212", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-212", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": { "h": 0.04, "w": 0.86, "x": 0.07, "y": 0.66 }, "kind": "callout", "text": "TransMedics allegedly obtained ACIN numbers for their surgeons by circumventing OPO licensing/credentialing procedures", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": null, "subkind": { "name": "Primary callout", "slug": "primary", "status": "active", "canonId": "019de52c-fbd1-70eb-a9ce-8997f8674c1d", "version": 1, "description": null }, "framework": null }, "subkind": "primary", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:34.275+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "33ff0d2a-c862-4629-a84b-d74eaabde117", "parentComponentId": null }, { "bbox": null, "kind": "callout", "text": "The ex-TransMedics surgeon stated that Attia was unlicensed to practice medicine in the US, and that an OPO may not grant an ACIN without extensive verification, which TransMedics surgeons would fail.", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:16+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a982-ad4212fbc948", "parentComponentId": null }, { "bbox": { "h": 0.45, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "paragraph", "text": "The ex-TransMedics surgeon laid out the gravity of the deception that would be required to improperly obtain ACIN credentials through an OPO, and pointed to Magdy Attia as an architect and/or participant of the alleged scheme. Attia appears to be a washed-out Egyptian transplant surgeon imported via the UK and appears to run the liver transplant program at TransMedics and oversee its surgeons. His name came up repeatedly during interviews, with multiple surgeons painting him as a henchman-type figure badgering and pressuring them to accept dubious organs they resisted – with one surgeon alleging that he lied to their center and hid that a liver was defective. The ex-TransMedics surgeon stated that Attia was unlicensed to practice medicine in the US, and that an OPO may not grant an ACIN without extensive verification, which TransMedics surgeons would fail: “all of them request a medical license to issue an ACIN for you...the OPO in New England...did not request the license...the OPO’s obligation is to make sure that this person is certified, licensed, and has the minimum training...if they’re not licensed to practice medicine in the US....but no, their surgeons practice like the top person on the liver side at TransMedics” – that is, Attia.", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:34.275+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "d3928e1c-b8a6-4669-b52b-d95893859b0d", "parentComponentId": null }, { "bbox": { "h": 0.25, "w": 0.86, "x": 0.07, "y": 0.7 }, "kind": "quote", "text": "A: “When [redacted - major organ procurement organization] hired me, they needed my license, my credentialing, the number of cases that I did, all of that. I actually contract with multiple OPO’s and all of them request a medical license to issue an ACIN for you. Apparently, the OPO in New England, they did not request their license...UNOS has the contract from the government to give authorization for transplant surgeons to recover organs. But surgeons don’t apply directly to UNOS. We apply to the OPO, and the OPO’s obligation is to make sure that this person is certified, licensed, and has the minimum training and this and that. To my understanding, if they’re not licensed to practice medicine in the United States - this is a form of practicing medicine. But no, they practice, like the top person on the liver side at TransMedics.” Q: “Who’s that person?” A: “Magdy Attia. I used to work in England. I don’t think he’s licensed to practice medicine in the United States.” Q: “What is his role at TransMedics?” A: “He is the chief of the liver program at TransMedics.” – Transplant procurement surgeon previously working with TransMedics", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:34.275+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "66220f59-ecf8-4ebc-84ae-75af1cf61503", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "“When [redacted - major organ procurement organization] hired me, they needed my license, my credentialing, the number of cases that I did, all of that. I actually contract with multiple OPO’s and all of them request a medical license to issue an ACIN for you. Apparently, the OPO in New England, they did not request their license...UNOS has the contract from the government to give authorization for transplant surgeons to recover organs. But surgeons don’t apply directly to UNOS. We apply to the OPO, and the OPO’s obligation is to make sure that this person is certified, licensed, and has the minimum training and this and that. To my understanding, if they’re not licensed to practice medicine in the United States - this is a form of practicing medicine. But no, they practice, like the top person on the liver side at TransMedics.” — Transplant procurement surgeon previously working with TransMedics", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:16+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a982-b32486c1bdbe", "parentComponentId": null }, { "bbox": { "h": 0.02, "w": 0.25, "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:34.275+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "df4b1d86-ac03-4579-9a16-df8a87c52801", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [ { "matchId": "6552ec20-af1b-4a32-813e-4c618172f139", "evidence": "The slide explicitly details an alleged scheme to circumvent regulatory credentialing requirements.", "framework": null, "confidence": 0.9, "extraction": { "at": "2026-05-02 20:12:34.275+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 212, "frameworkName": "fraud-exposure" } ], "arcBeats": [], "loops": [], "locked": true }, { "page": 213, "type": "tension", "title": "The slide uses a Q&A format to present expert testimony regarding TransMedics' NOP (National Organ Procurement) operations.", "function": "expose_contradiction", "rawType": "expose_contradiction", "block": null, "metadata": { "slideType": "expose_contradiction", "slideTypeCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-124c-75aa-984a-0a3d0d8fc8df", "version": 1, "description": null }, "function": "expose_contradiction", "functionCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-171f-776f-887c-73edaff4cf9c", "version": 1, "description": null }, "density": "dense", "densityScore": 57, "componentCount": 6, "textChars": 2415, "nDataPoints": 2, "notes": "The slide uses a Q&A format to present expert testimony regarding TransMedics' NOP (National Organ Procurement) operations.", "elementsJson": [ "paragraph", "quote_block", "footnote" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:12:34.286+00", "seconds": 3.327, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/213", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-213", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "The ex-TransMedics surgeon echoed others who called the use of unlicensed surgeons a “ticking time bomb” – “it’s their biggest risk...having people that don’t have licenses...I still don’t know how they did it.”", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:16+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a982-96c372cd831a", "parentComponentId": null }, { "bbox": { "h": 0.35, "w": 0.86, "x": 0.07, "y": 0.56 }, "kind": "list", "text": "Allegedly half of NOP surgeons are unlicensed; takes years to satisfy licensure requirements\nQ: “How many surgeons do you think they have now?”\nA: “I’m aware of 10-15 at least or even 20 full-time surgeons.”\nQ: “And how many of those are licensed?”\nA: “Maybe half, maybe a bit less than that, maybe half [...] do their surgeons have a license? No, they don’t.”\nQ: “Why can’t they get US-licensed physicians?”\nA: “That’s a lot of work. You need to do USMLE exams, which is four big exams. Like I did four exams. And then you need to get at least one year training. Some states will ask for two or three to be licensed in the US. You cannot get licensed without doing step exams which take at least two years. It’s a lot of work. It’s not something definitely you’re going to bring a full-blown surgeon at the age of 50 and ask him to do.” – Transplant procurement surgeon previously working with TransMedics", "attrs": null, "canon": { "kind": { "name": "List", "slug": "list", "status": "active", "canonId": "019de52c-f94b-779b-a53b-fd4904a5f4d2", "version": 1, "description": "Bullet or numbered list." }, "tool": null, "subkind": { "name": "Bullet list", "slug": "bullet", "status": "active", "canonId": "019de52c-fc98-7169-a083-5cab805076ca", "version": 1, "description": null }, "framework": null }, "subkind": "bullet", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:34.286+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "7aff2e74-5079-46e6-80b9-c14cc91e909f", "parentComponentId": null }, { "bbox": { "h": 0.35, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "paragraph", "text": "The ex-TransMedics surgeon echoed others who called the use of unlicensed surgeons a “ticking time bomb” – “it’s their biggest risk...having people that don’t have licenses...I still don’t know how they did it.” He stated that TransMedics NOP employs or contracts “10-15 at least or even 20 full-time surgeons” and that “maybe half, maybe a bit less” are licensed – “do their surgeons have a license? No, they don’t.” When we asked how long it takes to get licensed, he detailed the years of study, exams, fellowships and so forth he underwent for licensing, and stated it is unrealistic for TransMedics foreign-trained imports to do the same: “it’s a lot of work...it’s not something definitely you’re going to bring a full-blown surgeon at the age of 50 and ask him to do.”", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:34.286+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "ed81ae12-3bd8-4b34-8481-d5bbd1cfda75", "parentComponentId": null }, { "bbox": { "h": 0.1, "w": 0.86, "x": 0.07, "y": 0.45 }, "kind": "quote", "text": "“Biggest risk” is unlicensed surgeons ; ex-surgeon surprised they pulled it off\n“I mean, their biggest risk, I think is actually having people that don’t have licenses. I still don’t know how they did it.” -Transplant procurement surgeon previously working with TransMedics", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Pull quote", "slug": "pull-quote", "status": "active", "canonId": "019de52c-fbf9-76fe-97e1-a0b7540445c9", "version": 1, "description": null }, "framework": null }, "subkind": "pull-quote", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:34.286+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "f3e928f3-4bca-444d-9266-2c82823157ff", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "“I mean, their biggest risk, I think is actually having people that don’t have licenses. I still don’t know how they did it.” — Transplant procurement surgeon previously working with TransMedics", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:16+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a982-9bfa3edb67f4", "parentComponentId": null }, { "bbox": { "h": 0.03, "w": 0.3, "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:34.286+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "49a2049d-622c-4e70-af4b-bfd03d1019c4", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [ { "matchId": "9b1654f8-80f3-4727-99fe-24089e4091e4", "evidence": "The slide presents expert testimony to contradict the implied legitimacy of TransMedics' surgical staffing practices.", "framework": null, "confidence": 0.9, "extraction": { "at": "2026-05-02 20:12:34.286+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 213, "frameworkName": "expose_contradiction" } ], "arcBeats": [], "loops": [], "locked": true }, { "page": 214, "type": "tension", "title": "This is a highly aggressive, investigative-style slide typical of short-seller research reports.", "function": "name_villain", "rawType": "villain_critique", "block": null, "metadata": { "slideType": "villain_critique", "slideTypeCanon": { "name": "Villain critique", "slug": "villain_critique", "status": "active", "canonId": "019de52d-10bc-7136-bf20-09de59d17447", "version": 1, "description": null }, "function": "name_villain", "functionCanon": { "name": "Name villain", "slug": "name_villain", "status": "active", "canonId": "019de52d-1746-70d6-bc58-5eeaf5865526", "version": 1, "description": null }, "density": "balanced", "densityScore": 41, "componentCount": 5, "textChars": 1538, "nDataPoints": 0, "notes": "This is a highly aggressive, investigative-style slide typical of short-seller research reports.", "elementsJson": [ "paragraph", "screenshot", "photo", "footnote" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:12:33.834+00", "seconds": 2.773, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/214", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-214", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "Our checks on TransMedics procurement surgeons confirm the concerns raised by ex-employees, surgeons, OPO executives, and hospital staff – that a reasonable person may view them as generally unemployable by reputable transplant centers.", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:15+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a982-28fd5b4030ec", "parentComponentId": null }, { "bbox": { "h": 0.3, "w": 0.86, "x": 0.07, "y": 0.62 }, "kind": "image", "text": null, "attrs": null, "canon": { "kind": { "name": "Image", "slug": "image", "status": "active", "canonId": "019de52c-f978-701f-a720-51d029d769e7", "version": 1, "description": "Photo, illustration, screenshot or icon." }, "tool": null, "subkind": { "name": "Photo", "slug": "photo", "status": "active", "canonId": "019de52c-fd37-757f-b4a8-ca26d4888875", "version": 1, "description": null }, "framework": null }, "subkind": "photo", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:33.834+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "d45141b7-ad19-4aa1-999e-d344a132bd50", "parentComponentId": null }, { "bbox": { "h": 0.48, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "paragraph", "text": "Our checks on TransMedics procurement surgeons confirm the concerns raised by ex-employees, surgeons, OPO executives, and hospital staff – that a reasonable person may view them as generally unemployable by reputable transplant centers; that they are imported from high-risk foreign jurisdictions like India, Pakistan, and the Middle East; appear to be unlicensed to practice medicine in the US; and/or are associated with institutions abroad implicated in organ trafficking scandals. One TransMedics surgeon appears to be associated with one of the most gruesome medical device frauds in history, led by the infamous Paolo Macchiarini, who was charged with manslaughter for patient deaths and sentenced to prison. Another surgeon appears to be currently associated with a suspicious transplant tourism middleman in India. We begin with Magdy Attia, the “Chief of OCS Liver Transplant program at TransMedics” per his LinkedIn bio. An Egyptian import by way of the UK, an ex-TransMedics procurement surgeon alleged that he is unlicensed to practice medicine in the US.", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:33.834+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "2ef3caad-49c2-4078-b7ec-d1b29677d9ed", "parentComponentId": null }, { "bbox": { "h": 0.03, "w": 0.75, "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts; https://www.youtube.com/watch?v=QFil4AfBoH4; https://www.facebook.com/share/p/19fltDtDfA/", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:33.834+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "fd625c48-db33-425f-b9c3-139c78792f37", "parentComponentId": null }, { "bbox": { "h": 0.03, "w": 0.65, "x": 0.07, "y": 0.58 }, "kind": "title", "text": "Magdy Attia, shown last month as a speaker at the Egyptian Liver Transplantation Society", "attrs": null, "canon": { "kind": { "name": "Title", "slug": "title", "status": "active", "canonId": "019de52c-f7dd-76d9-b848-b1f12bd85cf4", "version": 1, "description": "Slide title or headline." }, "tool": null, "subkind": { "name": "Subtitle", "slug": "subtitle", "status": "active", "canonId": "019de52c-fb09-739d-900c-815b0d9ac526", "version": 1, "description": null }, "framework": null }, "subkind": "subtitle", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:33.834+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "bb2768b1-040f-49e1-9499-09ad97ff2332", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [], "arcBeats": [], "loops": [], "locked": true }, { "page": 215, "type": "tension", "title": "The slide uses a red arrow to connect a LinkedIn profile to a physical facility in Trinidad/Tobago to highlight the surgeon's dual employment.", "function": "expose_contradiction", "rawType": "expose_contradiction", "block": null, "metadata": { "slideType": "expose_contradiction", "slideTypeCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-124c-75aa-984a-0a3d0d8fc8df", "version": 1, "description": null }, "function": "expose_contradiction", "functionCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-171f-776f-887c-73edaff4cf9c", "version": 1, "description": null }, "density": "balanced", "densityScore": 38, "componentCount": 5, "textChars": 1352, "nDataPoints": 0, "notes": "The slide uses a red arrow to connect a LinkedIn profile to a physical facility in Trinidad/Tobago to highlight the surgeon's dual employment.", "elementsJson": [ "paragraph", "headshot", "screenshot", "photo", "footnote" ], "confidence": 0.95, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:12:33.794+00", "seconds": 2.725, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/215", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-215", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "Attia’s alleged lack of a license to practice medicine in the US is troubling, given that he appears to manage TransMedics procurement surgeons.", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:15+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a982-5b879c6bf6f1", "parentComponentId": null }, { "bbox": { "h": 0.41, "w": 0.86, "x": 0.07, "y": 0.51 }, "kind": "image", "text": "LinkedIn profile and Premier Heart Care facility photo", "attrs": null, "canon": { "kind": { "name": "Image", "slug": "image", "status": "active", "canonId": "019de52c-f978-701f-a720-51d029d769e7", "version": 1, "description": "Photo, illustration, screenshot or icon." }, "tool": null, "subkind": { "name": "Screenshot", "slug": "screenshot", "status": "active", "canonId": "019de52c-fd87-7509-8391-3d79fb339379", "version": 1, "description": null }, "framework": null }, "subkind": "screenshot", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:33.794+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "1a6b543c-fb3b-4f77-8937-48c6725b26d0", "parentComponentId": null }, { "bbox": { "h": 0.38, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "paragraph", "text": "Attia’s alleged lack of a license to practice medicine in the US is troubling, given that he appears to manage TransMedics procurement surgeons. The ex-TransMedics procurement surgeon pointed to Attia as not only recruiting many of these unlicensed surgeons, but as an architect or a participant of an alleged scheme to improperly obtain ACIN credentials for these surgeons via their local OPO, as detailed earlier: “they hired somebody from England” who “brought quite a large number” of surgeons who “were never trained in the United States...they’re not licensed to practice medicine.” For example, the “Associate Director of Cardiothoracic Surgical Services @ TransMedics” appears to have attended medical school in Jamaica, and his LinkedIn bio states he is also presently a surgeon at a facility in Trinidad/Tobago called Premier Heart care.", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:33.794+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "26247860-463e-4d92-a1e8-679bd45302bc", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "they hired somebody from England who brought quite a large number of surgeons who were never trained in the United States...they’re not licensed to practice medicine. — Ex-TransMedics procurement surgeon", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:15+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a982-5f9460a68818", "parentComponentId": null }, { "bbox": { "h": 0.04, "w": 0.86, "x": 0.07, "y": 0.93 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts; LinkedIn and Premier Heart Care website links.", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:33.794+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "4ef4e441-2e3f-42e3-b6b7-01aca817b7c2", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [], "arcBeats": [], "loops": [], "locked": true }, { "page": 216, "type": "appendix", "title": "The slide uses a 'villain' or 'exposing' framing to cast doubt on the company's hiring practices.", "function": "expose_contradiction", "rawType": "other", "block": null, "metadata": { "slideType": "other", "slideTypeCanon": { "name": "Other (fallback)", "slug": "other", "status": "active", "canonId": "019de52d-0af5-71ed-83de-d51ae245fc43", "version": 1, "description": null }, "function": "expose_contradiction", "functionCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-171f-776f-887c-73edaff4cf9c", "version": 1, "description": null }, "density": "balanced", "densityScore": 35, "componentCount": 5, "textChars": 1148, "nDataPoints": 0, "notes": "The slide uses a 'villain' or 'exposing' framing to cast doubt on the company's hiring practices.", "elementsJson": [ "headline_text", "subtitle_text", "headshot", "footnote" ], "confidence": 0.9, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:12:34.44+00", "seconds": 2.979, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/216", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-216", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "LinkedIn bios for other TransMedics surgeons lead us to think that thay are generally imported from India, Pakistan, Iraq, China, Eastern Europe, and so forth; have short tenures at the company of a year or two; and/or may be near the end of their careers.", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:16+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a982-c36d78f6ac61", "parentComponentId": null }, { "bbox": { "h": 0.58, "w": 0.86, "x": 0.07, "y": 0.26 }, "kind": "image", "text": null, "attrs": null, "canon": { "kind": { "name": "Image", "slug": "image", "status": "active", "canonId": "019de52c-f978-701f-a720-51d029d769e7", "version": 1, "description": "Photo, illustration, screenshot or icon." }, "tool": null, "subkind": { "name": "Headshot", "slug": "headshot", "status": "active", "canonId": "019de52c-fd5f-765c-9282-38b54f61bbbf", "version": 1, "description": null }, "framework": null }, "subkind": "headshot", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:34.44+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "9921b0cf-0376-457a-a371-c2587d54e0b9", "parentComponentId": null }, { "bbox": { "h": 0.08, "w": 0.86, "x": 0.07, "y": 0.9 }, "kind": "subtitle", "text": "Source: https://www.linkedin.com/in/donald-dafoe-932778310/; https://www.linkedin.com/in/marian-porubsky-6270011a6/; https://www.linkedin.com/in/anand-jothidasan-30656820a/; https://www.linkedin.com/in/james-zhan-b2019361/; https://www.linkedin.com/in/raffaelle-girlanda-md-642ab4282/; h; https://www.linkedin.com/in/farhan-zafar-6014b088/; https://www.linkedin.com/in/anant-dinesh-729123181/; https://www.linkedin.com/in/anurag-kaw-97882b14/recent-activity/comments/; https://www.linkedin.com/in/mazin-al-salihi-2738178b/", "attrs": null, "canon": { "kind": { "name": "Subtitle", "slug": "subtitle", "status": "active", "canonId": "82d821ee-2793-42e7-8f16-c6131385a3ce", "version": 1, "description": "Header-zone supporting text near the title (= ex body.description with bbox)." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:34.44+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "218bd930-36f1-479c-964a-1806ed89ef56", "parentComponentId": null }, { "bbox": { "h": 0.15, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "title", "text": "LinkedIn bios for other TransMedics surgeons lead us to think that thay are generally imported from India, Pakistan, Iraq, China, Eastern Europe, and so forth; have short tenures at the company of a year or two; and/or may be near the end of their careers. One even lists Delhi, India as his current location.", "attrs": null, "canon": { "kind": { "name": "Title", "slug": "title", "status": "active", "canonId": "019de52c-f7dd-76d9-b848-b1f12bd85cf4", "version": 1, "description": "Slide title or headline." }, "tool": null, "subkind": { "name": "Headline", "slug": "headline", "status": "active", "canonId": "019de52c-fae1-7463-9a7c-d60668eced0d", "version": 1, "description": null }, "framework": null }, "subkind": "headline", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:34.44+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "15a1ad5e-c222-4079-9219-92dbd26ba462", "parentComponentId": null }, { "bbox": { "h": 0.03, "w": 0.4, "x": 0.07, "y": 0.23 }, "kind": "title", "text": "LinkedIn bios for TransMedics procurement surgeons - excerpts", "attrs": null, "canon": { "kind": { "name": "Title", "slug": "title", "status": "active", "canonId": "019de52c-f7dd-76d9-b848-b1f12bd85cf4", "version": 1, "description": "Slide title or headline." }, "tool": null, "subkind": { "name": "Subtitle", "slug": "subtitle", "status": "active", "canonId": "019de52c-fb09-739d-900c-815b0d9ac526", "version": 1, "description": null }, "framework": null }, "subkind": "subtitle", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:34.44+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "78eae830-2a43-43c5-b59b-191f9ec07c94", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [], "arcBeats": [], "loops": [], "locked": true }, { "page": 217, "type": "tension", "title": "The slide uses screenshots of tweets to document the surgeon's use of derogatory language, which is highlighted with red boxes.", "function": "expose_contradiction", "rawType": "expose_contradiction", "block": null, "metadata": { "slideType": "expose_contradiction", "slideTypeCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-124c-75aa-984a-0a3d0d8fc8df", "version": 1, "description": null }, "function": "expose_contradiction", "functionCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-171f-776f-887c-73edaff4cf9c", "version": 1, "description": null }, "density": "balanced", "densityScore": 44, "componentCount": 6, "textChars": 1178, "nDataPoints": 1, "notes": "The slide uses screenshots of tweets to document the surgeon's use of derogatory language, which is highlighted with red boxes.", "elementsJson": [ "paragraph", "screenshot" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:12:34.738+00", "seconds": 2.806, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/217", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-217", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "Online chatter leads us to believe his affiliation with Stanford may have ended due to inflammatory statements on Twitter/X: “she’s a cunt,” referring to CNN reporter Christiane Amanpour.", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:16+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a982-f6ef2f5bd9b8", "parentComponentId": null }, { "bbox": { "h": 0.45, "w": 0.86, "x": 0.07, "y": 0.48 }, "kind": "image", "text": "Screenshots of tweets and Stanford Medicine statement", "attrs": null, "canon": { "kind": { "name": "Image", "slug": "image", "status": "active", "canonId": "019de52c-f978-701f-a720-51d029d769e7", "version": 1, "description": "Photo, illustration, screenshot or icon." }, "tool": null, "subkind": { "name": "Screenshot", "slug": "screenshot", "status": "active", "canonId": "019de52c-fd87-7509-8391-3d79fb339379", "version": 1, "description": null }, "framework": null }, "subkind": "screenshot", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:34.738+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "88ddb906-9709-44ec-9ec0-1aa6b8c3b9c4", "parentComponentId": null }, { "bbox": { "h": 0.25, "w": 0.86, "x": 0.07, "y": 0.16 }, "kind": "paragraph", "text": "One cardiothoracic surgeon, who lists TransMedics on his LinkedIn bio, was associated with Stanford per the same bio. His tenure appears to have ended abruptly around the time he ended up at TransMedics. Online chatter leads us to believe his affiliation with Stanford may have ended due to inflammatory statements on Twitter/X: “she’s a cunt,” referring to CNN reporter Christiane Amanpour. We count 10 tweets from his account in 2024 alone where he calls various individuals “cunt.” Stanford issued a terse statement on Twitter/X stating he is not affiliated with the institution.", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:34.738+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "134ebc59-ce14-42ee-bd32-3c11ee2492e7", "parentComponentId": null }, { "bbox": { "h": 0.08, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "paragraph", "text": "As examples, we detail the backgrounds of three surgeons who appear to work with or at TransMedics, which we suspect are representative, to illustrate the ex-executive's opinion of why they end up at TransMedics.", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:34.738+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "3c082527-706d-4837-b69a-9e3d443b6318", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "“She’s a cunt. There it needed to be said” — Alan Malki, M.D.", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:16+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a982-f90aac7d22ab", "parentComponentId": null }, { "bbox": { "h": 0.03, "w": 0.45, "x": 0.07, "y": 0.94 }, "kind": "source-note", "text": "Source: https://x.com/StanfordMed/status/1759754234474696875; https://x.com/_amalki", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:34.738+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "b90c6a66-11dc-4ee1-9092-3a95b02df168", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [], "arcBeats": [], "loops": [], "locked": true }, { "page": 218, "type": "tension", "title": "The slide uses screenshots of social media posts to establish a pattern of behavior.", "function": "expose_contradiction", "rawType": "expose_contradiction", "block": null, "metadata": { "slideType": "expose_contradiction", "slideTypeCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-124c-75aa-984a-0a3d0d8fc8df", "version": 1, "description": null }, "function": "expose_contradiction", "functionCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-171f-776f-887c-73edaff4cf9c", "version": 1, "description": null }, "density": "balanced", "densityScore": 27, "componentCount": 6, "textChars": 584, "nDataPoints": 0, "notes": "The slide uses screenshots of social media posts to establish a pattern of behavior.", "elementsJson": [ "headline_text", "subtitle_text", "screenshot", "headshot" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:12:34.166+00", "seconds": 2.187, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/218", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-218", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "The surgeon regularly makes incendiary statements on X.", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:16+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a982-da612b5570fa", "parentComponentId": null }, { "bbox": { "h": 0.65, "w": 0.85, "x": 0.07, "y": 0.0022 }, "kind": "image", "text": "LinkedIn profile and Twitter/X post screenshots", "attrs": null, "canon": { "kind": { "name": "Image", "slug": "image", "status": "active", "canonId": "019de52c-f978-701f-a720-51d029d769e7", "version": 1, "description": "Photo, illustration, screenshot or icon." }, "tool": null, "subkind": { "name": "Screenshot", "slug": "screenshot", "status": "active", "canonId": "019de52c-fd87-7509-8391-3d79fb339379", "version": 1, "description": null }, "framework": null }, "subkind": "screenshot", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:34.166+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "fe30c621-0371-4c6b-8c24-6678d24ead87", "parentComponentId": null }, { "bbox": { "h": 0.03, "w": 0.45, "x": 0.07, "y": 0.00185 }, "kind": "paragraph", "text": "LinkedIn bio, and social media profile/posts on Twitter/X", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:34.166+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "10823506-d075-4c90-97b2-07ae7ef874a4", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "Islam is fast growing by violence and intimidation. A so- called religion that deprives women its most basic rights where rape, honor killings and genital mutilation is a common occurrence that is encouraged. It's a disease not a religion. — Alan Malki, M.D.", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:16+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a982-dc61f54d9b10", "parentComponentId": null }, { "bbox": { "h": 0.02, "w": 0.4, "x": 0.07, "y": 0.93 }, "kind": "source-note", "text": "Source: https://www.linkedin.com/in/alan-malki-182b6026/; https://x.com/_amalki", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:34.166+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "34cda715-fd39-4f9e-92e9-0eee69f62f9e", "parentComponentId": null }, { "bbox": { "h": 0.08, "w": 0.85, "x": 0.07, "y": 0.07 }, "kind": "title", "text": "The surgeon regularly makes incendiary statements on X. We include a small sample below.", "attrs": null, "canon": { "kind": { "name": "Title", "slug": "title", "status": "active", "canonId": "019de52c-f7dd-76d9-b848-b1f12bd85cf4", "version": 1, "description": "Slide title or headline." }, "tool": null, "subkind": { "name": "Headline", "slug": "headline", "status": "active", "canonId": "019de52c-fae1-7463-9a7c-d60668eced0d", "version": 1, "description": null }, "framework": null }, "subkind": "headline", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:34.166+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "6345a7ed-c9d4-4858-b5d4-14b689638fb9", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [], "arcBeats": [], "loops": [], "locked": true }, { "page": 219, "type": "tension", "title": "This is a classic activist short-seller slide focusing on management/key personnel red flags.", "function": "expose_contradiction", "rawType": "villain_critique", "block": null, "metadata": { "slideType": "villain_critique", "slideTypeCanon": { "name": "Villain critique", "slug": "villain_critique", "status": "active", "canonId": "019de52d-10bc-7136-bf20-09de59d17447", "version": 1, "description": null }, "function": "expose_contradiction", "functionCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-171f-776f-887c-73edaff4cf9c", "version": 1, "description": null }, "density": "dense", "densityScore": 51, "componentCount": 6, "textChars": 1991, "nDataPoints": 0, "notes": "This is a classic activist short-seller slide focusing on management/key personnel red flags.", "elementsJson": [ "paragraph", "screenshot" ], "confidence": 0.95, "extraction": { "model": "google/gemini-3.5-flash", "runId": null, "at": "2026-07-17 03:49:52.842+00", "seconds": 7.356, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/219", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-219", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "Saverio LaFrancesca, a “Principal Cardiothoracic Surgeon,” was previously the President and Chief Medical Officer of Biostage (NASDAQ: BSTG), a micro-cap pump-and-dump engaged in quackery and which was involved with the notorious surgeon Paolo Macchiarini.", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:16+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a983-0ee29ca4c680", "parentComponentId": null }, { "bbox": { "h": 0.35, "w": 0.8, "x": 0.073, "y": 0.51 }, "kind": "image", "text": "Harvard Apparatus Regenerative Technology Promotes Chief Medical Officer Saverio La Francesca, M.D. to Executive Vice President\n-Dr. La Francesca leads scientific and clinical development including HART's second-generation bioengineered organ implant products-\nHarvard Apparatus Regenerative Technology Changes Name to Biostage, Inc. (NASDAQ: BSTG)", "attrs": null, "canon": { "kind": { "name": "Image", "slug": "image", "status": "active", "canonId": "019de52c-f978-701f-a720-51d029d769e7", "version": 1, "description": "Photo, illustration, screenshot or icon." }, "tool": null, "subkind": { "name": "Screenshot", "slug": "screenshot", "status": "active", "canonId": "019de52c-fd87-7509-8391-3d79fb339379", "version": 1, "description": null }, "framework": null }, "subkind": "screenshot", "groupRole": null, "confidence": null, "extraction": { "at": "2026-07-17 03:49:52.842+00", "model": "google/gemini-3.5-flash", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "ec90df8a-6e4e-445b-a909-2ea8eea8a1d8", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "“bioengineered trachea implant” – the initial surgical use of which “was led by Professor Paolo Macchiarini” — per the BSTG S-1.", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:16+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a983-12418ef30660", "parentComponentId": null }, { "bbox": { "h": 0.05, "w": 0.76, "x": 0.073, "y": 0.905 }, "kind": "source-note", "text": "Source: Biostage S-1 https://www.sec.gov/Archives/edgar/data/1563665/000155837022010152/tmb-20220621xs1.htm; https://www.businesswire.com/news/home/20150812005293/en/Harvard-Apparatus-Regenerative-Technology-Promotes-Chief-Medical-Officer-Saverio-La-Francesca-M.D.-to-Executive-Vice-President; https://www.prnewswire.com/news-releases/harvard-apparatus-regenerative-technology-changes-name-to-biostage-inc-nasdaq-bstg-300243888.html", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": "source-note", "groupRole": null, "confidence": null, "extraction": { "at": "2026-07-17 03:49:52.842+00", "model": "google/gemini-3.5-flash", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "77468c21-5b46-43d2-b919-c94437b8a4d3", "parentComponentId": null }, { "bbox": { "h": 0.052, "w": 0.77, "x": 0.073, "y": 0.441 }, "kind": "subtitle", "text": "Press release announcing Saveria La Francesco promotion and Harvard Apparatus name change to Biostage, 2015 and 2016 respectively", "attrs": null, "canon": { "kind": { "name": "Subtitle", "slug": "subtitle", "status": "active", "canonId": "82d821ee-2793-42e7-8f16-c6131385a3ce", "version": 1, "description": "Header-zone supporting text near the title (= ex body.description with bbox)." }, "tool": null, "subkind": null, "framework": null }, "subkind": "subtitle", "groupRole": null, "confidence": null, "extraction": { "at": "2026-07-17 03:49:52.842+00", "model": "google/gemini-3.5-flash", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "0a29fae4-8a22-429c-9c15-baa13f525ed0", "parentComponentId": null }, { "bbox": { "h": 0.348, "w": 0.865, "x": 0.073, "y": 0.071 }, "kind": "title", "text": "However, he is a sideshow relative to the far more suspect backgrounds of other TransMedics surgeons. Saverio LaFrancesca, a \"Principal Cardiothoracic Surgeon,\" was previously the President and Chief Medical Officer of Biostage (NASDAQ: BSTG), a micro-cap pump-and-dump engaged in quackery and which was involved with the notorious surgeon Paolo Macchiarini. BSTG was previously named Harvard Apparatus Regenerative Technology, and developed a \"bioengineered trachea implant\" – the initial surgical use of which \"was led by Professor Paolo Macchiarini\" per the BSTG S-1. A Harvard Apparatus press release noted La Francesca's promotion to EVP, after which he became President, per his LinkedIn bio.", "attrs": null, "canon": { "kind": { "name": "Title", "slug": "title", "status": "active", "canonId": "019de52c-f7dd-76d9-b848-b1f12bd85cf4", "version": 1, "description": "Slide title or headline." }, "tool": null, "subkind": { "name": "Action title", "slug": "action-title", "status": "active", "canonId": "019de52c-fb31-734c-a0f5-a3935b73135d", "version": 1, "description": null }, "framework": null }, "subkind": "action-title", "groupRole": null, "confidence": null, "extraction": { "at": "2026-07-17 03:49:52.842+00", "model": "google/gemini-3.5-flash", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "34d8f2f0-a592-42de-83ad-7cc0ef2d044e", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [], "arcBeats": [], "loops": [], "locked": true }, { "page": 220, "type": "tension", "title": "The slide uses screenshots of a LinkedIn profile and a scientific paper to establish a connection between the subject and specific companies.", "function": "expose_contradiction", "rawType": "expose_contradiction", "block": null, "metadata": { "slideType": "expose_contradiction", "slideTypeCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-124c-75aa-984a-0a3d0d8fc8df", "version": 1, "description": null }, "function": "expose_contradiction", "functionCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-171f-776f-887c-73edaff4cf9c", "version": 1, "description": null }, "density": "balanced", "densityScore": 33, "componentCount": 5, "textChars": 884, "nDataPoints": 1, "notes": "The slide uses screenshots of a LinkedIn profile and a scientific paper to establish a connection between the subject and specific companies.", "elementsJson": [ "paragraph", "screenshot", "footnote" ], "confidence": 0.95, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:12:35.049+00", "seconds": 2.664, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/220", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-220", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "His LinkedIn bio states he is “the company’s leading surgeon in California” and leads “approximately 100 surgical interventions each year.”", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:16+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a983-3d25d3ddd8e3", "parentComponentId": null }, { "bbox": { "h": 0.55, "w": 0.86, "x": 0.07, "y": 0.34 }, "kind": "image", "text": "Saverio La Francesca LinkedIn bio; TransMedics", "attrs": null, "canon": { "kind": { "name": "Image", "slug": "image", "status": "active", "canonId": "019de52c-f978-701f-a720-51d029d769e7", "version": 1, "description": "Photo, illustration, screenshot or icon." }, "tool": null, "subkind": { "name": "Screenshot", "slug": "screenshot", "status": "active", "canonId": "019de52c-fd87-7509-8391-3d79fb339379", "version": 1, "description": null }, "framework": null }, "subkind": "screenshot", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:35.049+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "21fc10e0-494c-4f27-8ca0-79f3700fbaf1", "parentComponentId": null }, { "bbox": { "h": 0.22, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "paragraph", "text": "Before we detail Paolo Macchiarini’s offenses, we note that La Francesca appears to play a meaningful role at TransMedics, and is listed as an author on its papers. His LinkedIn bio states he is “the company’s leading surgeon in California” and leads “approximately 100 surgical interventions each year.” The same bio spills extensive amounts of ink on his various roles at Biostage/Harvard Apparatus Regenerative Technology such as CMO, EVP, and then President and CMO.", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:35.049+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "3af88fb9-7e00-467f-b9fe-ab99a574c50b", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "“the company’s leading surgeon in California” — Saverio La Francesca LinkedIn bio", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:16+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a983-40786f64ce49", "parentComponentId": null }, { "bbox": { "h": 0.03, "w": 0.75, "x": 0.07, "y": 0.94 }, "kind": "source-note", "text": "Source: https://www.linkedin.com/in/saverio-lafrancesca/details/experience/; https://www.jhltonline.org/action/showPdf?pii=S1053-2498%2824%2901197-5", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:35.049+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "68b447ad-3864-48ff-baa0-55271cc7195b", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [], "arcBeats": [], "loops": [], "locked": true }, { "page": 221, "type": "tension", "title": "The slide uses visual evidence from the Internet Archive to contradict the company's attempt to distance itself from Macchiarini.", "function": "expose_contradiction", "rawType": "expose_contradiction", "block": null, "metadata": { "slideType": "expose_contradiction", "slideTypeCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-124c-75aa-984a-0a3d0d8fc8df", "version": 1, "description": null }, "function": "expose_contradiction", "functionCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-171f-776f-887c-73edaff4cf9c", "version": 1, "description": null }, "density": "balanced", "densityScore": 33, "componentCount": 6, "textChars": 832, "nDataPoints": 0, "notes": "The slide uses visual evidence from the Internet Archive to contradict the company's attempt to distance itself from Macchiarini.", "elementsJson": [ "paragraph", "screenshot" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:12:35.091+00", "seconds": 2.592, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/221", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-221", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "The IR page and presentations appear to have had no shortage of photos of Macchiarini.", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:16+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a983-25a01a301888", "parentComponentId": null }, { "bbox": { "h": 0.55, "w": 0.86, "x": 0.07, "y": 0.35 }, "kind": "image", "text": "Collage of archived website content showing Macchiarini and surgical procedures", "attrs": null, "canon": { "kind": { "name": "Image", "slug": "image", "status": "active", "canonId": "019de52c-f978-701f-a720-51d029d769e7", "version": 1, "description": "Photo, illustration, screenshot or icon." }, "tool": null, "subkind": { "name": "Screenshot", "slug": "screenshot", "status": "active", "canonId": "019de52c-fd87-7509-8391-3d79fb339379", "version": 1, "description": null }, "framework": null }, "subkind": "screenshot", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:35.091+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "8fe8515c-753b-47cb-b743-a4454ec182d1", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "The Patient was \"condemned to die\" — Prof. Macchiarini", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:16+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a983-2abb3a34b4f1", "parentComponentId": null }, { "bbox": { "h": 0.02, "w": 0.35, "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: https://www.linkedin.com/in/saverio-lafrancesca/details/experience/", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:35.091+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "523c55a4-8e23-45ab-8ff6-204583eef777", "parentComponentId": null }, { "bbox": { "h": 0.18, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "title", "text": "Harvard Apparatus Regenerative Technology, prior to its name change to Biostage, bet the farm on Paolo Macchiarini – despite attempts to quickly distance itself after his conduct came to light. We located various materials on Internet Archive’s Wayback Machine, such as company presentations, that showcase the trachea implants that Macchiarini would utilize. The IR page and presentations appear to have had no shortage of photos of Macchiarini.", "attrs": null, "canon": { "kind": { "name": "Title", "slug": "title", "status": "active", "canonId": "019de52c-f7dd-76d9-b848-b1f12bd85cf4", "version": 1, "description": "Slide title or headline." }, "tool": null, "subkind": { "name": "Headline", "slug": "headline", "status": "active", "canonId": "019de52c-fae1-7463-9a7c-d60668eced0d", "version": 1, "description": null }, "framework": null }, "subkind": "headline", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:35.091+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "dafe76e5-1317-454f-baf7-cb32331a52fe", "parentComponentId": null }, { "bbox": { "h": 0.03, "w": 0.46, "x": 0.07, "y": 0.31 }, "kind": "title", "text": "Harvard Apparatus Regenerative Technology – Internet Archive Wayback Machine screen captures", "attrs": null, "canon": { "kind": { "name": "Title", "slug": "title", "status": "active", "canonId": "019de52c-f7dd-76d9-b848-b1f12bd85cf4", "version": 1, "description": "Slide title or headline." }, "tool": null, "subkind": { "name": "Subtitle", "slug": "subtitle", "status": "active", "canonId": "019de52c-fb09-739d-900c-815b0d9ac526", "version": 1, "description": null }, "framework": null }, "subkind": "subtitle", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:35.091+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "2606b12e-655c-4431-9996-5a4408bd1570", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [ { "matchId": "6a441d11-5422-49b6-ba7c-3e3aeca0afef", "evidence": "The slide explicitly documents the company's association with a disgraced figure to expose a contradiction in their public narrative.", "framework": null, "confidence": 0.9, "extraction": { "at": "2026-05-02 20:12:35.091+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 221, "frameworkName": "fraud-exposure" } ], "arcBeats": [], "loops": [], "locked": true }, { "page": 222, "type": "tension", "title": "The slide uses external media references (Netflix, news headlines) to establish the severity of the fraud.", "function": "expose_contradiction", "rawType": "expose_contradiction", "block": null, "metadata": { "slideType": "expose_contradiction", "slideTypeCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-124c-75aa-984a-0a3d0d8fc8df", "version": 1, "description": null }, "function": "expose_contradiction", "functionCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-171f-776f-887c-73edaff4cf9c", "version": 1, "description": null }, "density": "dense", "densityScore": 74, "componentCount": 10, "textChars": 1502, "nDataPoints": 0, "notes": "The slide uses external media references (Netflix, news headlines) to establish the severity of the fraud.", "elementsJson": [ "paragraph", "screenshot", "other" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:12:36.416+00", "seconds": 3.903, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/222", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-222", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": { "h": 0.08, "w": 0.61, "x": 0.32, "y": 0.65 }, "kind": "callout", "text": "Disgraced surgeon Paolo Macchiarini, whose crimes inspired an opera, headed to prison", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": null, "subkind": { "name": "Primary callout", "slug": "primary", "status": "active", "canonId": "019de52c-fbd1-70eb-a9ce-8997f8674c1d", "version": 1, "description": null }, "framework": null }, "subkind": "primary", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:36.416+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "62db4ae8-98be-44cc-aa8f-083827e9ae2e", "parentComponentId": null }, { "bbox": null, "kind": "callout", "text": "The trachea implants that Macchiarini employed turned out to be one of the most gruesome cases of medical device quackery and fraud in history.", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:16+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a983-a84233bdaff3", "parentComponentId": null }, { "bbox": { "h": 0.22, "w": 0.23, "x": 0.07, "y": 0.65 }, "kind": "image", "text": "Paolo Macchiarini portrait", "attrs": null, "canon": { "kind": { "name": "Image", "slug": "image", "status": "active", "canonId": "019de52c-f978-701f-a720-51d029d769e7", "version": 1, "description": "Photo, illustration, screenshot or icon." }, "tool": null, "subkind": { "name": "Photo", "slug": "photo", "status": "active", "canonId": "019de52c-fd37-757f-b4a8-ca26d4888875", "version": 1, "description": null }, "framework": null }, "subkind": "photo", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:36.416+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "f8383c26-785a-4640-bb43-60d5fac2d68c", "parentComponentId": null }, { "bbox": { "h": 0.18, "w": 0.33, "x": 0.07, "y": 0.38 }, "kind": "image", "text": "Netflix series episodes", "attrs": null, "canon": { "kind": { "name": "Image", "slug": "image", "status": "active", "canonId": "019de52c-f978-701f-a720-51d029d769e7", "version": 1, "description": "Photo, illustration, screenshot or icon." }, "tool": null, "subkind": { "name": "Screenshot", "slug": "screenshot", "status": "active", "canonId": "019de52c-fd87-7509-8391-3d79fb339379", "version": 1, "description": null }, "framework": null }, "subkind": "screenshot", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:36.416+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "c168df1b-940a-4186-b7a9-7c533a991981", "parentComponentId": null }, { "bbox": { "h": 0.18, "w": 0.5, "x": 0.43, "y": 0.38 }, "kind": "list", "text": "Holliston's Biostage faces wrongful death suit over organ implant surgery. As Surgeon Paolo Macchiarini Faces Charges, Biostage Pushes Ahead With New Tech", "attrs": null, "canon": { "kind": { "name": "List", "slug": "list", "status": "active", "canonId": "019de52c-f94b-779b-a53b-fd4904a5f4d2", "version": 1, "description": "Bullet or numbered list." }, "tool": null, "subkind": { "name": "Bullet list", "slug": "bullet", "status": "active", "canonId": "019de52c-fc98-7169-a083-5cab805076ca", "version": 1, "description": null }, "framework": null }, "subkind": "bullet", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:36.416+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "7c1da576-e922-4deb-b707-f4f460116539", "parentComponentId": null }, { "bbox": { "h": 0.15, "w": 0.86, "x": 0.07, "y": 0.15 }, "kind": "paragraph", "text": "Seven of his eight patients died. Biostage was sued. Macchiarini’s patients who had their tracheas removed died “horrible, painful deaths” – with the one who sued Biostage being left to “cough up pieces of her own flesh.” Macchiarini was convicted of various crimes and sentenced to prison, becoming internationally infamous and the subject of a Netflix series as well as an opera.", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:36.416+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "00b01a7c-daf3-4f01-96bf-f0df6636442c", "parentComponentId": null }, { "bbox": { "h": 0.12, "w": 0.61, "x": 0.32, "y": 0.75 }, "kind": "paragraph", "text": "Dr Con Man: the rise and fall of a celebrity scientist who fooled almost everyone", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:36.416+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "e4be03ae-a0e1-4ff4-a3e8-b98c8425a99a", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "“horrible, painful deaths” — Unspecified source regarding Macchiarini's patients.", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:16+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a983-ae33451b7464", "parentComponentId": null }, { "bbox": { "h": 0.05, "w": 0.75, "x": 0.07, "y": 0.92 }, "kind": "source-note", "text": "Source: https://www.biospace.com/as-surgeon-b-paolo-macchiarini-b-faces-charges-biostage-pushes-ahead-with-new-tech; https://www.bizjournals.com/boston/news/2018/04/10/hollistons-biostage-faces-wrongful-death-suit-over.html; https://www.netflix.com/title/81607097; https://www.science.org/content/article/disgraced-surgeon-paolo-macchiarini-whose-crimes-inspired-opera-headed-to-prison", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:36.416+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "05f07748-5920-46bc-aea3-1c07b571ecc3", "parentComponentId": null }, { "bbox": { "h": 0.15, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "title", "text": "The trachea implants that Macchiarini employed turned out to be one of the most gruesome cases of medical device quackery and fraud in history.", "attrs": null, "canon": { "kind": { "name": "Title", "slug": "title", "status": "active", "canonId": "019de52c-f7dd-76d9-b848-b1f12bd85cf4", "version": 1, "description": "Slide title or headline." }, "tool": null, "subkind": { "name": "Headline", "slug": "headline", "status": "active", "canonId": "019de52c-fae1-7463-9a7c-d60668eced0d", "version": 1, "description": null }, "framework": null }, "subkind": "headline", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:36.416+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "92f69b37-c276-4b2c-b3c6-321235d95e02", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [], "arcBeats": [], "loops": [], "locked": true }, { "page": 223, "type": "tension", "title": "The slide uses visual evidence (red boxes and arrows) to link a specific surgeon's LinkedIn profile to news articles about organ trafficking.", "function": "expose_contradiction", "rawType": "expose_contradiction", "block": null, "metadata": { "slideType": "expose_contradiction", "slideTypeCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-124c-75aa-984a-0a3d0d8fc8df", "version": 1, "description": null }, "function": "expose_contradiction", "functionCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-171f-776f-887c-73edaff4cf9c", "version": 1, "description": null }, "density": "dense", "densityScore": 60, "componentCount": 8, "textChars": 1354, "nDataPoints": 0, "notes": "The slide uses visual evidence (red boxes and arrows) to link a specific surgeon's LinkedIn profile to news articles about organ trafficking.", "elementsJson": [ "paragraph", "headshot", "screenshot", "footnote" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:12:35.981+00", "seconds": 3.403, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/223", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-223", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "His LinkedIn Bio shows only two years of total surgical experience – in India – before joining TransMedics.", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:16+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a983-5be780f56d1c", "parentComponentId": null }, { "bbox": { "h": 0.45, "w": 0.35, "x": 0.07, "y": 0.42 }, "kind": "image", "text": "LinkedIn profile snippet for Yashavanth kumar", "attrs": null, "canon": { "kind": { "name": "Image", "slug": "image", "status": "active", "canonId": "019de52c-f978-701f-a720-51d029d769e7", "version": 1, "description": "Photo, illustration, screenshot or icon." }, "tool": null, "subkind": { "name": "Screenshot", "slug": "screenshot", "status": "active", "canonId": "019de52c-fd87-7509-8391-3d79fb339379", "version": 1, "description": null }, "framework": null }, "subkind": "screenshot", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:35.981+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "2045df9a-f15b-4fa1-b126-5ce784581991", "parentComponentId": null }, { "bbox": { "h": 0.45, "w": 0.55, "x": 0.38, "y": 0.42 }, "kind": "image", "text": "News headlines regarding Apollo Hospitals and organ trafficking", "attrs": null, "canon": { "kind": { "name": "Image", "slug": "image", "status": "active", "canonId": "019de52c-f978-701f-a720-51d029d769e7", "version": 1, "description": "Photo, illustration, screenshot or icon." }, "tool": null, "subkind": { "name": "Screenshot", "slug": "screenshot", "status": "active", "canonId": "019de52c-fd87-7509-8391-3d79fb339379", "version": 1, "description": null }, "framework": null }, "subkind": "screenshot", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:35.981+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "414a064c-3895-4b4c-bb16-ca23de644642", "parentComponentId": null }, { "bbox": { "h": 0.15, "w": 0.86, "x": 0.07, "y": 0.22 }, "kind": "paragraph", "text": "Shortly afterward, the site was taken off-line and the contact numbers no longer work. However, his profile is still visible on a cached version at Internet Archive’s Wayback Machine. The surgeon is an import from India who appears to have arrived in the US a year ago. We note that he previously worked at Apollo Hospitals, which was implicated in organ trafficking schemes in 2016 and 2023. His LinkedIn Bio shows only two years of total surgical experience – in India – before joining TransMedics.", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:35.981+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "be1d66d2-5940-4bba-9f7e-39feef71e853", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "Revealed: Global private hospital group embroiled in ‘cash for kidneys’ racket — The Telegraph", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:16+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a983-5e7916969a90", "parentComponentId": null }, { "bbox": { "h": 0.03, "w": 0.86, "x": 0.07, "y": 0.37 }, "kind": "source-note", "text": "TransMedics surgeon – LinkedIn bio; Apollo Hospitals organ trafficking allegations – press coverage", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:35.981+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "32b364db-cda0-4c8c-a884-acd064aa2a03", "parentComponentId": null }, { "bbox": { "h": 0.05, "w": 0.86, "x": 0.07, "y": 0.94 }, "kind": "source-note", "text": "Source: https://www.linkedin.com/in/yashavanth-kumar-313ab531/; https://www.telegraph.co.uk/global-health/science-and-disease/kidney-organ-trafficking-scandal-private-healthcare-india-myanmar/; https://www.telegraph.co.uk/global-health/climate-and-people/cash-for-kidneys-hospital-in-new-organ-trafficking-claims/", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:35.981+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "cb9449fb-d6ed-4388-ad71-af670e244b0d", "parentComponentId": null }, { "bbox": { "h": 0.15, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "title", "text": "When we did a name search for another TransMedics surgeon, his bio came up on the page of a suspect transplant tourism site in India.", "attrs": null, "canon": { "kind": { "name": "Title", "slug": "title", "status": "active", "canonId": "019de52c-f7dd-76d9-b848-b1f12bd85cf4", "version": 1, "description": "Slide title or headline." }, "tool": null, "subkind": { "name": "Headline", "slug": "headline", "status": "active", "canonId": "019de52c-fae1-7463-9a7c-d60668eced0d", "version": 1, "description": null }, "framework": null }, "subkind": "headline", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:35.981+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "57914316-67fa-4523-919b-59c580503ae3", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [], "arcBeats": [], "loops": [], "locked": true }, { "page": 224, "type": "tension", "title": "Uses juxtaposition of a news headline about arrests and a photo of a surgeon receiving a national award to highlight the contradiction.", "function": "expose_contradiction", "rawType": "expose_contradiction", "block": null, "metadata": { "slideType": "expose_contradiction", "slideTypeCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-124c-75aa-984a-0a3d0d8fc8df", "version": 1, "description": null }, "function": "expose_contradiction", "functionCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-171f-776f-887c-73edaff4cf9c", "version": 1, "description": null }, "density": "dense", "densityScore": 70, "componentCount": 9, "textChars": 1510, "nDataPoints": 0, "notes": "Uses juxtaposition of a news headline about arrests and a photo of a surgeon receiving a national award to highlight the contradiction.", "elementsJson": [ "paragraph", "screenshot", "photo", "footnote" ], "confidence": 0.95, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:12:36.248+00", "seconds": 3.48, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/224", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-224", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": { "h": 0.03, "w": 0.45, "x": 0.07, "y": 0.37 }, "kind": "callout", "text": "Apollo Hospitals - 2016 and 2023 organ trafficking scandals, respectively", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": null, "subkind": { "name": "Primary callout", "slug": "primary", "status": "active", "canonId": "019de52c-fbd1-70eb-a9ce-8997f8674c1d", "version": 1, "description": null }, "framework": null }, "subkind": "primary", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:36.248+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "0ac828ed-a1be-425d-a8b9-9dc3643251fb", "parentComponentId": null }, { "bbox": null, "kind": "callout", "text": "Apollo Hospitals seems to be a recidivist when it comes to organ trafficking scandals – which seems par for the course for hospitals in major cities in India.", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:16+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a983-882ab486a844", "parentComponentId": null }, { "bbox": { "h": 0.35, "w": 0.42, "x": 0.51, "y": 0.53 }, "kind": "image", "text": null, "attrs": null, "canon": { "kind": { "name": "Image", "slug": "image", "status": "active", "canonId": "019de52c-f978-701f-a720-51d029d769e7", "version": 1, "description": "Photo, illustration, screenshot or icon." }, "tool": null, "subkind": { "name": "Photo", "slug": "photo", "status": "active", "canonId": "019de52c-fd37-757f-b4a8-ca26d4888875", "version": 1, "description": null }, "framework": null }, "subkind": "photo", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:36.248+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "74a9f286-0516-4a24-951a-efdd27f57297", "parentComponentId": null }, { "bbox": { "h": 0.35, "w": 0.35, "x": 0.07, "y": 0.53 }, "kind": "image", "text": null, "attrs": null, "canon": { "kind": { "name": "Image", "slug": "image", "status": "active", "canonId": "019de52c-f978-701f-a720-51d029d769e7", "version": 1, "description": "Photo, illustration, screenshot or icon." }, "tool": null, "subkind": { "name": "Screenshot", "slug": "screenshot", "status": "active", "canonId": "019de52c-fd87-7509-8391-3d79fb339379", "version": 1, "description": null }, "framework": null }, "subkind": "screenshot", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:36.248+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "fdb2228d-be16-4924-bf98-6023a4c6857b", "parentComponentId": null }, { "bbox": { "h": 0.1, "w": 0.35, "x": 0.07, "y": 0.41 }, "kind": "paragraph", "text": "Kidney Racket Busted In Delhi's Apollo Hospital, 5 Persons Arrested", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:36.248+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "9515968b-ec2c-45ba-bf19-13b404de2ed5", "parentComponentId": null }, { "bbox": { "h": 0.1, "w": 0.42, "x": 0.51, "y": 0.41 }, "kind": "paragraph", "text": "One of India's leading medics, Dr Sandeep Guleria – who trained in the UK and received one of the nation's highest honours, the Padma Shri, for his services to medicine – was named by patients and agents as the surgeon who conducted the transplants.", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:36.248+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "d0098b16-d27c-4689-8ab5-f16733eab030", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "Dr. Sandeep Guleria – who trained in the UK...was named by recipients and agents as the surgeon who conducted the transplants. — The Telegraph", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:16+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a983-8d3693a12761", "parentComponentId": null }, { "bbox": { "h": 0.05, "w": 0.8, "x": 0.07, "y": 0.94 }, "kind": "source-note", "text": "Source: https://www.ndtv.com/delhi-news/kidney-racket-busted-in-delhis-apollo-hospital-5-persons-arrested-1415359; https://www.telegraph.co.uk/global-health/science-and-disease/kidney-organ-trafficking-scandal-private-healthcare-india-myanmar/", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:36.248+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "bed0fec0-b339-440f-90df-b4e4fa5058a3", "parentComponentId": null }, { "bbox": { "h": 0.25, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "title", "text": "Apollo Hospitals seems to be a recidivist when it comes to organ trafficking scandals – which seems par for the course for hospitals in major cities in India. In 2016, five individuals at Apollo were arrested. In the 2023 scandal, The Telegraph implicated Sandeep Guleria, one of India’s most prominent transplant surgeons and a Padma Shri awardee, one the country’s highest honors, indicating the level of rot that pervades India’s transplant field – “Dr. Sandeep Guleria – who trained in the UK…was named by recipients and agents as the surgeon who conducted the transplants.”", "attrs": null, "canon": { "kind": { "name": "Title", "slug": "title", "status": "active", "canonId": "019de52c-f7dd-76d9-b848-b1f12bd85cf4", "version": 1, "description": "Slide title or headline." }, "tool": null, "subkind": { "name": "Headline", "slug": "headline", "status": "active", "canonId": "019de52c-fae1-7463-9a7c-d60668eced0d", "version": 1, "description": null }, "framework": null }, "subkind": "headline", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:36.248+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "9ad50203-71fe-4156-aa7c-0034434962d6", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [ { "matchId": "3c7db0bb-7ff1-468d-80d1-6ace43b05441", "evidence": "Juxtaposition of award-winning surgeon image with criminal allegations", "framework": null, "confidence": 0.8, "extraction": { "at": "2026-05-02 20:12:36.248+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 224, "frameworkName": "ceo-quote-contradiction" } ], "arcBeats": [], "loops": [], "locked": true }, { "page": 225, "type": "tension", "title": "The slide uses screenshots as evidence to link a medical professional to a controversial third-party platform.", "function": "expose_contradiction", "rawType": "expose_contradiction", "block": null, "metadata": { "slideType": "expose_contradiction", "slideTypeCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-124c-75aa-984a-0a3d0d8fc8df", "version": 1, "description": null }, "function": "expose_contradiction", "functionCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-171f-776f-887c-73edaff4cf9c", "version": 1, "description": null }, "density": "balanced", "densityScore": 46, "componentCount": 7, "textChars": 1052, "nDataPoints": 0, "notes": "The slide uses screenshots as evidence to link a medical professional to a controversial third-party platform.", "elementsJson": [ "paragraph", "screenshot" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:12:36.028+00", "seconds": 3.083, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/225", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-225", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "Similat middlemen are at the center of recent trafficking scandals at Apollo and elsewhere.", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:17+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a984-24cb1b168a62", "parentComponentId": null }, { "bbox": { "h": 0.45, "w": 0.37, "x": 0.56, "y": 0.42 }, "kind": "image", "text": "Screenshot of Instagram profile for Transplantcounsellor", "attrs": null, "canon": { "kind": { "name": "Image", "slug": "image", "status": "active", "canonId": "019de52c-f978-701f-a720-51d029d769e7", "version": 1, "description": "Photo, illustration, screenshot or icon." }, "tool": null, "subkind": { "name": "Screenshot", "slug": "screenshot", "status": "active", "canonId": "019de52c-fd87-7509-8391-3d79fb339379", "version": 1, "description": null }, "framework": null }, "subkind": "screenshot", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:36.028+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "305ac04c-6666-459e-9f4c-d0ebb7937c65", "parentComponentId": null }, { "bbox": { "h": 0.25, "w": 0.45, "x": 0.07, "y": 0.42 }, "kind": "image", "text": "Screenshot of Transplantcounsellor.com website", "attrs": null, "canon": { "kind": { "name": "Image", "slug": "image", "status": "active", "canonId": "019de52c-f978-701f-a720-51d029d769e7", "version": 1, "description": "Photo, illustration, screenshot or icon." }, "tool": null, "subkind": { "name": "Screenshot", "slug": "screenshot", "status": "active", "canonId": "019de52c-fd87-7509-8391-3d79fb339379", "version": 1, "description": null }, "framework": null }, "subkind": "screenshot", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:36.028+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "6288d9bb-136b-4b53-bd05-1dc554aeae7c", "parentComponentId": null }, { "bbox": { "h": 0.25, "w": 0.45, "x": 0.07, "y": 0.68 }, "kind": "image", "text": "Screenshot of Dr. Yashavanth Kumar V profile", "attrs": null, "canon": { "kind": { "name": "Image", "slug": "image", "status": "active", "canonId": "019de52c-f978-701f-a720-51d029d769e7", "version": 1, "description": "Photo, illustration, screenshot or icon." }, "tool": null, "subkind": { "name": "Screenshot", "slug": "screenshot", "status": "active", "canonId": "019de52c-fd87-7509-8391-3d79fb339379", "version": 1, "description": null }, "framework": null }, "subkind": "screenshot", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:36.028+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "81b90394-2dba-4307-a3d4-98df5804d4ad", "parentComponentId": null }, { "bbox": { "h": 0.28, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "paragraph", "text": "We recognize that Apollo Hospitals is a large Indian chain and make no allegation that this TransMedics surgeon was involved in any scheme. Nonetheless, we are troubled to see his profile on an Indian site called Transplantcounsellor.com, run by a transplant middleman/broker with an aggressive, promotional social media presence – who states in his bio he is focused on transplant tourism. Similat middlemen are at the center of recent trafficking scandals at Apollo and elsewhere. India is a leading destination for foreigners seeking illegal organ transplants, particularly from Persian Gulf states like Dubai.", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:36.028+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "4684e1a6-ad8b-4ef9-bf24-1c8acec89b04", "parentComponentId": null }, { "bbox": { "h": 0.02, "w": 0.5, "x": 0.07, "y": 0.37 }, "kind": "source-note", "text": "Transplantcounsellor.com cached page shows TransMedics surgeon bio; broker’s Instagram profile", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:36.028+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "1034131d-bf6e-4082-953c-afab49eca82b", "parentComponentId": null }, { "bbox": { "h": 0.02, "w": 0.5, "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: https://web.archive.org/web/20240417080729/https://transplantcounsellor.com/doctor-details.aspx?id=1", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:36.028+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "c0d16c8f-c3cc-4b66-9847-058ea7670c1c", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [ { "matchId": "9594ef1b-f75a-4b49-ae60-8966aab523f8", "evidence": "The slide explicitly links a professional to a known broker to expose potential unethical behavior.", "framework": null, "confidence": 0.9, "extraction": { "at": "2026-05-02 20:12:36.028+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 225, "frameworkName": "fraud-exposure" } ], "arcBeats": [], "loops": [], "locked": true }, { "page": 226, "type": "tension", "title": "The slide uses a combination of LinkedIn profile screenshots and a news headline to build a case of guilt by association.", "function": "expose_contradiction", "rawType": "expose_contradiction", "block": null, "metadata": { "slideType": "expose_contradiction", "slideTypeCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-124c-75aa-984a-0a3d0d8fc8df", "version": 1, "description": null }, "function": "expose_contradiction", "functionCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-171f-776f-887c-73edaff4cf9c", "version": 1, "description": null }, "density": "dense", "densityScore": 61, "componentCount": 8, "textChars": 1434, "nDataPoints": 0, "notes": "The slide uses a combination of LinkedIn profile screenshots and a news headline to build a case of guilt by association.", "elementsJson": [ "paragraph", "screenshot", "footnote" ], "confidence": 0.95, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:12:35.965+00", "seconds": 2.89, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/226", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-226", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "Apollo doctor held for Bangladesh-India kidney transplant ‘racket’", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:16+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a983-dc4bc84b020f", "parentComponentId": null }, { "bbox": { "h": 0.45, "w": 0.4, "x": 0.07, "y": 0.46 }, "kind": "image", "text": "LinkedIn profile details", "attrs": null, "canon": { "kind": { "name": "Image", "slug": "image", "status": "active", "canonId": "019de52c-f978-701f-a720-51d029d769e7", "version": 1, "description": "Photo, illustration, screenshot or icon." }, "tool": null, "subkind": { "name": "Screenshot", "slug": "screenshot", "status": "active", "canonId": "019de52c-fd87-7509-8391-3d79fb339379", "version": 1, "description": null }, "framework": null }, "subkind": "screenshot", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:35.965+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "e925918b-c996-4dcb-9ef5-bcd288862c40", "parentComponentId": null }, { "bbox": { "h": 0.28, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "paragraph", "text": "The individual behind Transplantcounsellor.com runs various accounts online, such as one for liver transplants, as well on Twitter/X, LinkedIn, and perhaps other platforms. His LinkedIn bio indicates his parent entity is focused on transplant tourism – and mentions living donor transplants, which we understand to be illegal in India unless from a relative. Living donor transplants are, of course, at the center of cash-for-organs schemes. We note also that his LinkedIn bio shows that he worked at Indraprastha Apollo Hospitals New Delhi – one of the Apollo hospital locations implicated in organ trafficking – as well as endorsements from colleagues there.", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:35.965+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "118898eb-49e1-42f2-a5be-ad7bae91a9bc", "parentComponentId": null }, { "bbox": { "h": 0.08, "w": 0.5, "x": 0.43, "y": 0.7 }, "kind": "paragraph", "text": "Last week, Delhi Police arrested a 50-year-old doctor from Delhi-based Indraprastha Apollo Hospital for her alleged involvement in an organ transplantation racket across Bangladesh and India.", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:35.965+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "da775917-4cf5-4343-bf1a-f9f1a68886c9", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "Last week, Delhi Police arrested a 50-year-old doctor from Delhi-based Indraprastha Apollo Hospital for her alleged involvement in an organ transplantation racket across Bangladesh and India. — Indian Express", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:16+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a983-e2ec211167fa", "parentComponentId": null }, { "bbox": { "h": 0.04, "w": 0.86, "x": 0.07, "y": 0.94 }, "kind": "source-note", "text": "Source: https://www.linkedin.com/in/transplantcounsellor/; https://indianexpress.com/article/cities/delhi/apollo-doctor-held-for-bangladesh-india-kidney-transplant-racket-9441228/", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:35.965+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "f5e5a7f5-d2a0-472d-b713-c3523205280c", "parentComponentId": null }, { "bbox": { "h": 0.03, "w": 0.4, "x": 0.07, "y": 0.42 }, "kind": "title", "text": "Transplant Counsellor CEO – LinkedIn bio", "attrs": null, "canon": { "kind": { "name": "Title", "slug": "title", "status": "active", "canonId": "019de52c-f7dd-76d9-b848-b1f12bd85cf4", "version": 1, "description": "Slide title or headline." }, "tool": null, "subkind": { "name": "Headline", "slug": "headline", "status": "active", "canonId": "019de52c-fae1-7463-9a7c-d60668eced0d", "version": 1, "description": null }, "framework": null }, "subkind": "headline", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:35.965+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "6a5f7c7a-1dd4-4fb9-8393-10bd232d1e41", "parentComponentId": null }, { "bbox": { "h": 0.08, "w": 0.5, "x": 0.43, "y": 0.61 }, "kind": "title", "text": "Apollo doctor held for Bangladesh-India kidney transplant ‘racket’", "attrs": null, "canon": { "kind": { "name": "Title", "slug": "title", "status": "active", "canonId": "019de52c-f7dd-76d9-b848-b1f12bd85cf4", "version": 1, "description": "Slide title or headline." }, "tool": null, "subkind": { "name": "Headline", "slug": "headline", "status": "active", "canonId": "019de52c-fae1-7463-9a7c-d60668eced0d", "version": 1, "description": null }, "framework": null }, "subkind": "headline", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:35.965+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "843f70b9-655d-4c52-8f0a-2ee4970b2336", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [], "arcBeats": [], "loops": [], "locked": true }, { "page": 227, "type": "tension", "title": "This slide serves as a specific accusation or 'villain' critique within a research note.", "function": "name_villain", "rawType": "villain_critique", "block": null, "metadata": { "slideType": "villain_critique", "slideTypeCanon": { "name": "Villain critique", "slug": "villain_critique", "status": "active", "canonId": "019de52d-10bc-7136-bf20-09de59d17447", "version": 1, "description": null }, "function": "name_villain", "functionCanon": { "name": "Name villain", "slug": "name_villain", "status": "active", "canonId": "019de52d-1746-70d6-bc58-5eeaf5865526", "version": 1, "description": null }, "density": "sparse", "densityScore": 10, "componentCount": 2, "textChars": 478, "nDataPoints": 0, "notes": "This slide serves as a specific accusation or 'villain' critique within a research note.", "elementsJson": [ "paragraph" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:12:35.396+00", "seconds": 1.91, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/227", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-227", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "Part 8. The NOP service, we believe, traffics in and pushes unsafe, damaged organs rejected by reputable centers, as an unplaced organ means loss of device and aircraft fees; with TransMedics allegedly concealing adverse organ information.", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:16+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a983-7b2d0823657a", "parentComponentId": null }, { "bbox": { "h": 0.15, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "paragraph", "text": "Part 8. The NOP service, we believe, traffics in and pushes unsafe, damaged organs rejected by reputable centers, as an unplaced organ means loss of device and aircraft fees; with TransMedics allegedly concealing adverse organ information.", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:35.396+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "231c87dd-1122-4a4c-80f8-ccae061eee87", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [], "arcBeats": [], "loops": [], "locked": true }, { "page": 228, "type": "tension", "title": "The slide uses a Q&A format to highlight alleged unethical practices regarding organ safety and corporate pressure.", "function": "name_villain", "rawType": "villain_critique", "block": null, "metadata": { "slideType": "villain_critique", "slideTypeCanon": { "name": "Villain critique", "slug": "villain_critique", "status": "active", "canonId": "019de52d-10bc-7136-bf20-09de59d17447", "version": 1, "description": null }, "function": "name_villain", "functionCanon": { "name": "Name villain", "slug": "name_villain", "status": "active", "canonId": "019de52d-1746-70d6-bc58-5eeaf5865526", "version": 1, "description": null }, "density": "dense", "densityScore": 58, "componentCount": 6, "textChars": 2654, "nDataPoints": 2, "notes": "The slide uses a Q&A format to highlight alleged unethical practices regarding organ safety and corporate pressure.", "elementsJson": [ "paragraph", "quote_block", "footnote" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:12:37.61+00", "seconds": 3.86, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/228", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-228", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": { "h": 0.25, "w": 0.86, "x": 0.07, "y": 0.68 }, "kind": "callout", "text": "Allegedly ignored their procurement surgeons’ judgment that a liver is not usable\nA: “The fact that I didn’t want to really work with TransMedics anymore is due to their not respecting the professional judgment of the surgeon and pushing for stuff that might not be reasonable or safe from the perspective of a transplant surgeon.”\nQ: “Who was pushing in a way it was not safe?”\nA: “On every case, at least two to three people watching this case from TransMedics.”\nQ: “What are they pushing that you think that doesn’t respect the judgment of the transplant surgeon?”\nA: “They don’t want you to give professional judgments. They want you to do the job, that’s it.” – Transplant procurement surgeon previously working with TransMedics", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": null, "subkind": { "name": "Primary callout", "slug": "primary", "status": "active", "canonId": "019de52c-fbd1-70eb-a9ce-8997f8674c1d", "version": 1, "description": null }, "framework": null }, "subkind": "primary", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:37.61+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "60c97c62-9939-4b3e-ad06-de04988a5d0e", "parentComponentId": null }, { "bbox": null, "kind": "callout", "text": "We believe that a key part of TransMedics modus operandi is preventing its procurement surgeons from communicating with recipient surgeons and centers, in order to conceal or overrule their concerns about defective or unusable organs when they arrive at the donor site.", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:16+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a984-0c2baa436c2a", "parentComponentId": null }, { "bbox": { "h": 0.25, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "paragraph", "text": "We believe that a key part of TransMedics modus operandi is preventing its procurement surgeons from communicating with recipient surgeons and centers, in order to conceal or overrule their concerns about defective or unusable organs when they arrive at the donor site – any organ not accepted means the loss of $90,000 in device revenue plus potentially another $25,000 to $300,000 in dubious air transport charges.", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:37.61+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "491f686c-c05d-4151-ba1e-da06f0a8cb63", "parentComponentId": null }, { "bbox": { "h": 0.35, "w": 0.86, "x": 0.07, "y": 0.32 }, "kind": "paragraph", "text": "An ex-procurement surgeon who worked with TransMedics – who was “one of the top three surgeons” and “probably did 100 to 150 livers – stated he resigned because TransMedics was “not respecting the professional judgement of the surgeon and pushing for stuff that might not be reasonable or safe from the perspective of the transplant surgeon.” When we asked who was pushing to retrieve and put unsafe organs on the device, he stated it was the headquarters, which we interpret as the executive team given color from other ex-employees about their alleged active participation on internal case chats: “on every case, at least two or three people watching this case from TransMedics...they don’t want you to give professional judgments...they want you to do the job, that’s it.”", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:37.61+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "5bdff4e4-861d-42a8-8f5e-d8eb0f89471f", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "The fact that I didn't want to really work with TransMedics anymore is due to their not respecting the professional judgment of the surgeon and pushing for stuff that might not be reasonable or safe from the perspective of a transplant surgeon. They don't want you to give professional judgments. They want you to do the job, that's it. — Transplant procurement surgeon previously working with TransMedics", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:16+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a984-109957793cd5", "parentComponentId": null }, { "bbox": { "h": 0.03, "w": 0.3, "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:37.61+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "948d44bc-18b9-473e-a786-0020cafcbdb0", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [ { "matchId": "e0eac642-a409-4f3e-9d1a-4bfe0d7da9a1", "evidence": "The slide explicitly frames TransMedics as a villain prioritizing revenue over safety.", "framework": null, "confidence": 0.9, "extraction": { "at": "2026-05-02 20:12:37.61+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 228, "frameworkName": "antagonist-introduction" } ], "arcBeats": [], "loops": [], "locked": true }, { "page": 229, "type": "tension", "title": "The slide uses a Q&A format to highlight a perceived ethical conflict between corporate procurement goals and clinical safety standards.", "function": "expose_contradiction", "rawType": "expose_contradiction", "block": null, "metadata": { "slideType": "expose_contradiction", "slideTypeCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-124c-75aa-984a-0a3d0d8fc8df", "version": 1, "description": null }, "function": "expose_contradiction", "functionCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-171f-776f-887c-73edaff4cf9c", "version": 1, "description": null }, "density": "dense", "densityScore": 63, "componentCount": 7, "textChars": 3132, "nDataPoints": 0, "notes": "The slide uses a Q&A format to highlight a perceived ethical conflict between corporate procurement goals and clinical safety standards.", "elementsJson": [ "paragraph", "quote_block", "footnote" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:12:37.822+00", "seconds": 3.945, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/229", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-229", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "When he told TransMedics an organ was unsuitable, they would disingenuously say “the machine will do the trick...the transplant centers...make the judgement” – a disingenuous ploy as “the transplant program who’s accepting the liver is not here...if I don’t tell them my professional judgment, they don’t know....it was simply, just put the liver on the pump.”", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:18+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a985-01f0ad21de26", "parentComponentId": null }, { "bbox": { "h": 0.03, "w": 0.3, "x": 0.07, "y": 0.52 }, "kind": "list", "text": "Pressure to send any and all livers to centers", "attrs": null, "canon": { "kind": { "name": "List", "slug": "list", "status": "active", "canonId": "019de52c-f94b-779b-a53b-fd4904a5f4d2", "version": 1, "description": "Bullet or numbered list." }, "tool": null, "subkind": { "name": "Bullet list", "slug": "bullet", "status": "active", "canonId": "019de52c-fc98-7169-a083-5cab805076ca", "version": 1, "description": null }, "framework": null }, "subkind": "bullet", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:37.822+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "6fc397a1-c439-42e2-99da-cfb7e670ce3c", "parentComponentId": null }, { "bbox": { "h": 0.35, "w": 0.86, "x": 0.07, "y": 0.56 }, "kind": "paragraph", "text": "Q: \"What there would make you uncomfortable? What would they ask you to do that a surgeon may not want to do?\"\nA: \"Some organs, I don't think they're safe for transplant. I think they might not work, or they might not work long enough, or they're not very good for a transplant, and this is my professional judgment that every transplant surgeon - maybe I've done 800 of these transplants or more than a thousand..., we know for sure and we hear from the transplant centers which organ can work. I trained for years, so when a liver doesn't work, it's a disaster.\"\nQ: \"Give me some examples or some anecdotes. You would, as a surgeon say, I don't think this liver is going to work. And the three administrators or whatever at TransMedics, what would they say? They would say, shut up and do your job and get the liver?\"\nA: \"They would say that we don't make those decisions. Those decisions are going to be for the transplant program, but the transplant program who's accepting this liver is not here. They are not here. If I don't tell them my professional judgment, they don't know. The say the machine will do the trick. It may work on the machine; it may not work on the machine. The transplant centers are the ones who make the judgment. Our job is to provide the procurement service - it was simply, just put the liver on the pump.\" – Transplant procurement surgeon previously working with TransMedics", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:37.822+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "3025dc9c-46ff-4e16-b1b4-14bf5574f40a", "parentComponentId": null }, { "bbox": { "h": 0.25, "w": 0.86, "x": 0.07, "y": 0.22 }, "kind": "paragraph", "text": "We asked the surgeon what the company required that made him uncomfortable: \"Some organs, I don't think they're safe for transplant. I think they might not work, or they might not work long enough...this is my professional judgment...maybe I've done 800 of these transplants or more than a thousand...I trained for years, so when a liver doesn't work, it's a disaster.\" When he told TransMedics an organ was unsuitable, they would disingenuously say \"the machine will do the trick...the transplant centers...make the judgement\" – a disingenuous ploy as \"the transplant program who's accepting the liver is not here...if I don't tell them my professional judgment, they don't know....it was simply, just put the liver on the pump.\"", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:37.822+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "c615c95f-4ab2-4b59-bdc3-9def3c9621bf", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "“Some organs, I don’t think they’re safe for transplant. I think they might not work, or they might not work long enough...this is my professional judgment...maybe I’ve done 800 of these transplants or more than a thousand...I trained for years, so when a liver doesn’t work, it’s a disaster.” — Transplant procurement surgeon previously working with TransMedics", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:18+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a985-078b6ead086c", "parentComponentId": null }, { "bbox": { "h": 0.02, "w": 0.3, "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:37.822+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "4c10b2ec-e0df-442d-a16a-810bb93a9f8b", "parentComponentId": null }, { "bbox": { "h": 0.15, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "title", "text": "The surgeon's color was alarming - that TransMedics NOP is allegedly seeking to retrieve and sling any organ onto the device no matter how unsafe to the receiving patient.", "attrs": null, "canon": { "kind": { "name": "Title", "slug": "title", "status": "active", "canonId": "019de52c-f7dd-76d9-b848-b1f12bd85cf4", "version": 1, "description": "Slide title or headline." }, "tool": null, "subkind": { "name": "Headline", "slug": "headline", "status": "active", "canonId": "019de52c-fae1-7463-9a7c-d60668eced0d", "version": 1, "description": null }, "framework": null }, "subkind": "headline", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:37.822+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "d3d679df-a240-45f1-9738-deab27950ed0", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [ { "matchId": "c2df9669-e3d3-4645-986e-7f55d96ff58c", "evidence": "The slide presents testimony to expose a contradiction between company claims and clinical practice.", "framework": null, "confidence": 0.8, "extraction": { "at": "2026-05-02 20:12:37.822+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 229, "frameworkName": "fraud-exposure" } ], "arcBeats": [], "loops": [], "locked": true }, { "page": 230, "type": "tension", "title": "The slide uses a Q&A format to highlight the alleged restriction of professional judgment.", "function": "expose_contradiction", "rawType": "expose_contradiction", "block": null, "metadata": { "slideType": "expose_contradiction", "slideTypeCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-124c-75aa-984a-0a3d0d8fc8df", "version": 1, "description": null }, "function": "expose_contradiction", "functionCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-171f-776f-887c-73edaff4cf9c", "version": 1, "description": null }, "density": "balanced", "densityScore": 41, "componentCount": 5, "textChars": 1518, "nDataPoints": 0, "notes": "The slide uses a Q&A format to highlight the alleged restriction of professional judgment.", "elementsJson": [ "paragraph", "quote_block" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:12:36.817+00", "seconds": 2.888, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/230", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-230", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "No, all the communication goes through the TransMedics people.", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:16+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a983-f97fd2cbc9c6", "parentComponentId": null }, { "bbox": { "h": 0.35, "w": 0.86, "x": 0.07, "y": 0.35 }, "kind": "paragraph", "text": "Surgeons allegedly prevented from communicating with receiving centers to relay their concerns\nQ: “Would they let you communicate that to the transplant center? Or they wouldn’t let you communicate your judgment?”\nA: “Very much the latter. My judgment - everything is going to go through TransMedics; nothing is going directly most of the time.”\nQ: “When you said I don’t think it’s a good organ and they would say let the transplant center decide. Would they let you tell the transplant center your judgment?”\nA: “No, all the communication goes through the TransMedics people.” – Transplant procurement surgeon previously working with TransMedics", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:36.817+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "591ed069-7f97-4b40-ac87-175249b58530", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "“Very much the latter. My judgment - everything is going to go through TransMedics; nothing is going directly most of the time.” — Transplant procurement surgeon previously working with TransMedics", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:16+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a983-fd9a5238e0c5", "parentComponentId": null }, { "bbox": { "h": 0.03, "w": 0.3, "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:36.817+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "a2f759c6-26c5-4bf3-9285-6bfa1c679e67", "parentComponentId": null }, { "bbox": { "h": 0.22, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "title", "text": "He described control exercised by TransMedics to shut off the retrieval surgeon’s ability to communicate his/her professional judgement about the organs they are sent to retrieve, and stated that all communication was routed through a case coordinator: “my judgement – everything is going through TransMedics; nothing is doing directly most of the time….” If he felt an organ was unsuitable for transplant, he indicated he was not allowed to relay his concerns to the surgeon waiting for it: “no, all the communication goes through the TransMedics people.”", "attrs": null, "canon": { "kind": { "name": "Title", "slug": "title", "status": "active", "canonId": "019de52c-f7dd-76d9-b848-b1f12bd85cf4", "version": 1, "description": "Slide title or headline." }, "tool": null, "subkind": { "name": "Headline", "slug": "headline", "status": "active", "canonId": "019de52c-fae1-7463-9a7c-d60668eced0d", "version": 1, "description": null }, "framework": null }, "subkind": "headline", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:36.817+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "59b35b02-fb22-45fd-a87c-8e0b0cf1c11f", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [], "arcBeats": [], "loops": [], "locked": true }, { "page": 231, "type": "tension", "title": "The slide uses a Q&A format to highlight a breakdown in the standard organ procurement process.", "function": "name_villain", "rawType": "villain_critique", "block": null, "metadata": { "slideType": "villain_critique", "slideTypeCanon": { "name": "Villain critique", "slug": "villain_critique", "status": "active", "canonId": "019de52d-10bc-7136-bf20-09de59d17447", "version": 1, "description": null }, "function": "name_villain", "functionCanon": { "name": "Name villain", "slug": "name_villain", "status": "active", "canonId": "019de52d-1746-70d6-bc58-5eeaf5865526", "version": 1, "description": null }, "density": "balanced", "densityScore": 48, "componentCount": 5, "textChars": 2601, "nDataPoints": 0, "notes": "The slide uses a Q&A format to highlight a breakdown in the standard organ procurement process.", "elementsJson": [ "paragraph", "quote_block", "footnote" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:12:37.489+00", "seconds": 3.47, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/231", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-231", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": { "h": 0.05, "w": 0.86, "x": 0.07, "y": 0.55 }, "kind": "callout", "text": "Allegedly keeping their own procurement surgeons in the dark; refuse to even tell them if a liver worked or was even transplanted", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": null, "subkind": { "name": "Primary callout", "slug": "primary", "status": "active", "canonId": "019de52c-fbd1-70eb-a9ce-8997f8674c1d", "version": 1, "description": null }, "framework": null }, "subkind": "primary", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:37.489+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "05a37493-5ba0-4705-916e-560b7da2414b", "parentComponentId": null }, { "bbox": { "h": 0.45, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "paragraph", "text": "The surgeon stated he was kept completely in the dark, and that in cases where he concluded the organ was defective or otherwise not appropriate for transplant, that he doubted that TransMedics communicated his professional judgement as the procuring surgeon to the recipient center – “I don’t think so. In our field, if a receiving surgeon hears that the recovery surgeon said I don’t think the organ should go, it’s very unlikely it will go...very unlikely.” He added that he wasn’t even told if the organs he procured were transplanted or not – particularly the ones he thought were unsuitable – and that no information was ever shared about outcomes after transplant, a complete circumvention of a typical organ procurement process: “I don’t even know if that organ ended up transplant...I don’t even know if it did well afterwards or not...we’re not in communication with transplant centers...they don’t even tell us...we don’t know...we simply don’t know.”", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:37.489+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "2bf5e32c-e7b0-4592-ade4-ebe9a5446f1c", "parentComponentId": null }, { "bbox": { "h": 0.25, "w": 0.86, "x": 0.07, "y": 0.6 }, "kind": "quote", "text": "Q: “So, there were times when you told the TransMedics person your professional judgment as a surgeon that the organ didn’t make sense, and you have no idea if they communicated that or not.”\nA: “I don’t think so. In our field, if a receiving surgeon hears that the recovery surgeon said I don’t think he organ should go, it’s very unlikely he will go. Very unlikely...I don’t even know if that organ ended up transplanted or not. I don’t even know if it did well afterwards or not. We’re not in communication with the transplant centers... they don’t even tell us if this organ got transplanted or not or if this organ ended up transplanted and is doing well or not. We don’t know. We simply don’t know.”\nQ: “So, TransMedics didn’t share any information with the transplant surgeons about outcomes?”\nA: “No.”– Transplant procurement surgeon previously working with TransMedics", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:37.489+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "e27d4518-05c4-4bee-b444-0aa652dc4c8b", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "I don't think so. In our field, if a receiving surgeon hears that the recovery surgeon said I don't think he organ should go, it's very unlikely he will go. Very unlikely...I don't even know if that organ ended up transplanted or not. I don't even know if it did well afterwards or not. We're not in communication with the transplant centers... they don't even tell us if this organ got transplanted or not or if this organ ended up transplanted and is doing well or not. We don't know. We simply don't know. — Transplant procurement surgeon previously working with TransMedics", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:17+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a984-3d04225eeb6e", "parentComponentId": null }, { "bbox": { "h": 0.02, "w": 0.3, "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:37.489+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "a3220b27-d736-4aed-8a15-9df79b9c8251", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [], "arcBeats": [], "loops": [], "locked": true }, { "page": 232, "type": "tension", "title": "The slide uses a Q&A format to highlight a potential conflict of interest or operational risk regarding TransMedics' NOP service.", "function": "expose_contradiction", "rawType": "expose_contradiction", "block": null, "metadata": { "slideType": "expose_contradiction", "slideTypeCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-124c-75aa-984a-0a3d0d8fc8df", "version": 1, "description": null }, "function": "expose_contradiction", "functionCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-171f-776f-887c-73edaff4cf9c", "version": 1, "description": null }, "density": "dense", "densityScore": 63, "componentCount": 7, "textChars": 2900, "nDataPoints": 0, "notes": "The slide uses a Q&A format to highlight a potential conflict of interest or operational risk regarding TransMedics' NOP service.", "elementsJson": [ "paragraph", "quote_block", "footnote" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:12:37.785+00", "seconds": 3.672, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/232", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-232", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "TransMedics allegedly makes and controls the decision on whether an organ is accepted", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:17+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a984-69a86cd299d7", "parentComponentId": null }, { "bbox": { "h": 0.45, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "paragraph", "text": "Our calls lead us to conclude that it is TransMedics NOP service that controls whether an organ is deemed suitable for recovery and transplant – not the recipient center’s surgeon, who is not in the operating room for retrieval - thereby giving it the ability to withhold adverse information. A senior medical employee at OrganOx, a competitor with a near-identical normothermic pump, stated he has spoken with numerous centers, who indicated that TransMedics makes the call on whether an organ is usable and whether to put in on the pump, as part of the soup-to-nuts NOP service: \"TransMedics is taking care of literally everything...actually I’m unaware if the decision is even made by the transplanting surgeon because once TransMedics takes the organ from the donor...they can make the call right then and there...if you have a lousy organ...and they’re already worried...and it doesn’t look good...they should discard it right then, but they don’t...what I have heard is that once the organ goes into the hands of TransMedics...the receiving team has very little input on anything that happens....\"", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:37.785+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "0b0d3e5d-987e-4c31-b133-c3d751ef5df0", "parentComponentId": null }, { "bbox": { "h": 0.06, "w": 0.86, "x": 0.07, "y": 0.84 }, "kind": "paragraph", "text": "Q: “Where have you heard that TransMedics has all of the control over the organ, and they’re the ones to make the decision? I think they’re very hesitant about admitting that.”\nA: “I heard that directly from healthcare workers while I was on sites, from hospitals.” – Senior medical employee at OrganOx", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:37.785+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "c99c40c6-e203-4f90-82a7-2f92b32b9a01", "parentComponentId": null }, { "bbox": { "h": 0.18, "w": 0.86, "x": 0.07, "y": 0.66 }, "kind": "quote", "text": "A: “TransMedics is taking care of literally everything up until that point...actually, I’m unaware if the decision to discard the organ is even made by the transplanting surgeon because once TransMedics takes the organ from the donor, I believe they can make the call right then and there. So, if you have a lousy organ coming out and the transaminase are in the thousands or something, and they’re already worried about it and it doesn’t look good, they should discard it right then, but they don’t because they’re not footing the bill...what I have heard is that once the organ goes into the hands of TransMedics, once the donation is made, the receiving team has very little input on anything that happens.”", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:37.785+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "a7012bdf-7ffd-47ff-9fc6-1173b5c43e8b", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "“TransMedics is taking care of literally everything...actually I’m unaware if the decision is even made by the transplanting surgeon because once TransMedics takes the organ from the donor...they can make the call right then and there...if you have a lousy organ...and they’re already worried...and it doesn’t look good...they should discard it right then, but they don’t...what I have heard is that once the organ goes into the hands of TransMedics...the receiving team has very little input on anything that happens....” — Senior medical employee at OrganOx", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:17+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a984-6c21bc9094f2", "parentComponentId": null }, { "bbox": { "h": 0.02, "w": 0.3, "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:37.785+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "67821518-bc4e-4761-b7e7-57848142f89c", "parentComponentId": null }, { "bbox": { "h": 0.04, "w": 0.86, "x": 0.07, "y": 0.62 }, "kind": "title", "text": "TransMedics allegedly makes and controls the decision on whether an organ is accepted", "attrs": null, "canon": { "kind": { "name": "Title", "slug": "title", "status": "active", "canonId": "019de52c-f7dd-76d9-b848-b1f12bd85cf4", "version": 1, "description": "Slide title or headline." }, "tool": null, "subkind": { "name": "Action title", "slug": "action-title", "status": "active", "canonId": "019de52c-fb31-734c-a0f5-a3935b73135d", "version": 1, "description": null }, "framework": null }, "subkind": "action-title", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:37.785+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "bf671e96-0d27-43d7-9e64-bbe397fb6299", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [ { "matchId": "688e916e-2c39-49c6-a647-a1995cf7bb54", "evidence": "The slide contrasts the implied standard of care (surgeon control) with the alleged reality (TransMedics control).", "framework": null, "confidence": 0.9, "extraction": { "at": "2026-05-02 20:12:37.785+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 232, "frameworkName": "expose_contradiction" } ], "arcBeats": [], "loops": [], "locked": true }, { "page": 233, "type": "tension", "title": "The slide uses testimonials from an OrganOx employee and a transplant cardiologist to argue that TransMedics' model strips control from hospitals and relies on ", "function": "expose_contradiction", "rawType": "expose_contradiction", "block": null, "metadata": { "slideType": "expose_contradiction", "slideTypeCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-124c-75aa-984a-0a3d0d8fc8df", "version": 1, "description": null }, "function": "expose_contradiction", "functionCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-171f-776f-887c-73edaff4cf9c", "version": 1, "description": null }, "density": "dense", "densityScore": 63, "componentCount": 7, "textChars": 3027, "nDataPoints": 0, "notes": "The slide uses testimonials from an OrganOx employee and a transplant cardiologist to argue that TransMedics' model strips control from hospitals and relies on inadequate communication methods like cell phone videos.", "elementsJson": [ "paragraph", "quote_block", "footnote" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:12:37.634+00", "seconds": 3.445, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/233", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-233", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "The potential for abuse is self-evident, given that TransMedics naturally has a perverse incentive to never reject an organ no matter how dubious.", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:17+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a984-a8d50c107636", "parentComponentId": null }, { "bbox": { "h": 0.25, "w": 0.86, "x": 0.07, "y": 0.2 }, "kind": "paragraph", "text": "The OrganOx employee in a clinical role noted complaints from hospital sites he has visited, with centers dismayed at their lack of control: “...autonomy is huge...I get the sense that’s being stripped away...that entire process is controlled by TransMedics...little autonomy that the surgeon has until the organ actually reaches the recipient...that’s the pattern that we’ve seen.” A transplant cardiologist at Vanderbilt – one of the busiest centers in the world, which has cut off most TransMedics usage – lamented their experience with the NOP service and dependence on surgeons they didn’t trust: “just sending you cell phone videos of...what the heart looks like...it makes it very challenging if there’s some injury...during...dissecting out that heart.”", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:37.634+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "d8ae5561-81c9-49e6-8e0e-f51181d71ebd", "parentComponentId": null }, { "bbox": { "h": 0.18, "w": 0.86, "x": 0.07, "y": 0.48 }, "kind": "quote", "text": "“Entire process” of organ procurement and decision-making is “controlled by TransMedics”; stripped control from centers “Autonomy, I think, is big with healthcare providers... that entire process is controlled by TransMedics. So, there’s little autonomy that the surgeon has until the organ actually reaches the recipient. And that’s something that I believe surgeons don’t really like...that’s the pattern that we’ve seen.” - Senior medical employee at OrganOx", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:37.634+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "8afadf15-b2ff-444d-9c08-dffa1a381e01", "parentComponentId": null }, { "bbox": { "h": 0.25, "w": 0.86, "x": 0.07, "y": 0.7 }, "kind": "quote", "text": "Receiving centers receiving haphazard organ info via “cell phone videos” A: “The other thing that’s really driven us away from this is they were essentially mandating, requiring you to use their surgeons and their procurement teams for these hearts... It’s harder to do this when a team that you don’t work with on a regular basis is just sending you cell phone videos of this is what the heart looks like, etc..” Q: “That’s how it works with their team? They’re sending cell phone videos to the team on the other end to see if they like it?” A: “It’s like phone calls and cell phone videos and that’s it, yeah... It makes it very challenging if there’s some injury that happened during the donor chest opening and dissecting out that heart.” - Transplant cardiologist at one of the top centers in the US/world", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:37.634+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "cd935c63-3116-4491-af14-8c516827d211", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "“...autonomy is huge...I get the sense that’s being stripped away...that entire process is controlled by TransMedics...little autonomy that the surgeon has until the organ actually reaches the recipient...that’s the pattern that we’ve seen.” — Senior medical employee at OrganOx; “It’s like phone calls and cell phone videos and that’s it, yeah. Because none of our team members are there, so that’s the only way if there are any concerns whatsoever. It makes it very challenging if there’s some injury that happened during the donor chest opening and dissecting out that heart.” — Transplant cardiologist at one of the top centers in the US/world", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:17+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a984-ae96f7afc256", "parentComponentId": null }, { "bbox": { "h": 0.02, "w": 0.25, "x": 0.07, "y": 0.96 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:37.634+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "24da46e1-2851-4c84-9acb-46b600998075", "parentComponentId": null }, { "bbox": { "h": 0.12, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "title", "text": "The potential for abuse is self-evident, given that TransMedics naturally has a perverse incentive to never reject an organ no matter how dubious.", "attrs": null, "canon": { "kind": { "name": "Title", "slug": "title", "status": "active", "canonId": "019de52c-f7dd-76d9-b848-b1f12bd85cf4", "version": 1, "description": "Slide title or headline." }, "tool": null, "subkind": { "name": "Headline", "slug": "headline", "status": "active", "canonId": "019de52c-fae1-7463-9a7c-d60668eced0d", "version": 1, "description": null }, "framework": null }, "subkind": "headline", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:37.634+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "3c5c951f-d783-4339-8af5-54bb8c88a7eb", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [], "arcBeats": [], "loops": [], "locked": true }, { "page": 234, "type": "tension", "title": "The slide uses a Q&A format to substantiate claims of surgical incompetence and unethical organ distribution practices.", "function": "expose_contradiction", "rawType": "expose_contradiction", "block": null, "metadata": { "slideType": "expose_contradiction", "slideTypeCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-124c-75aa-984a-0a3d0d8fc8df", "version": 1, "description": null }, "function": "expose_contradiction", "functionCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-171f-776f-887c-73edaff4cf9c", "version": 1, "description": null }, "density": "balanced", "densityScore": 48, "componentCount": 5, "textChars": 2587, "nDataPoints": 0, "notes": "The slide uses a Q&A format to substantiate claims of surgical incompetence and unethical organ distribution practices.", "elementsJson": [ "paragraph", "quote_block", "footnote" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:12:37.582+00", "seconds": 3.319, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/234", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-234", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "Some livers were refused on cases I was on because they took too long from incision to getting the liver out or they took too long between cross-clamp and reconstruction.", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:17+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a984-52808c443086", "parentComponentId": null }, { "bbox": { "h": 0.35, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "paragraph", "text": "Ex-employees who traveled and worked with TransMedics NOP surgeons in the operating room during organ recoveries provided smoking gun information that leads us to conclude that TransMedics pawns rejected and damaged organs to other centers – such as those that took longer than 30-minutes for their surgeons to retrieve, past the limit for warm ischemia time after which the organ rapidly deteriorates – and then allegedly may withhold or misrepresent the info from/to receiving centers. A former OCS Specialist, who resigned due to a litany of disturbing practices - the device technicians who transfer, manage, and transport organs on pumps - stated organs would experience “a couple of hours” of warm ischemia due to the surgeons’ inability to remove them within the defined period, and replied “basically, yeah” when we asked if they would then just pawn them off to another center.", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:37.582+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "2f80ddef-f3a3-4a92-b233-c2a0a33a2543", "parentComponentId": null }, { "bbox": { "h": 0.35, "w": 0.86, "x": 0.07, "y": 0.52 }, "kind": "quote", "text": "Surgeons incompetent with long ischemic times; don't know how to pull out livers; pawning damaged livers to other centers\nA: “Their surgeons could benefit from more experience. Surgeons have so much training in residency and fellowship. Their surgeons did not get that experience. They would benefit from it, when you’re talking about ischemia time for an organ and reconstruction.”\nQ: “What would happen? They were just too slow and fumbling and not able to take it out within the proper ischemic time.?”\nA: “Yes. Some livers were refused on cases I was on because they took too long from incision to getting the liver out or they took too long between cross-clamp and reconstruction. They spent too long on the reconstruction, so they were like, this liver has been out too long, and I don’t want it now.”\nQ: “And then they would just pawn it off to another center?”\nA: “Basically, yeah.”\nQ: “How long would these ischemic times go because they were not properly experienced?”\nA: “It depends if there’s reconstruction or not. Like a couple of hours.” - Former TransMedics OCS specialist", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:37.582+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "49b96bd9-1126-458a-9f10-85b773ebfa78", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "“Yes. Some livers were refused on cases I was on because they took too long from incision to getting the liver out or they took too long between cross-clamp and reconstruction. They spent too long on the reconstruction, so they were like, this liver has been out too long, and I don't want it now.” ... “Basically, yeah.” ... “Like a couple of hours.” — Former TransMedics OCS specialist", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:17+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a984-579c9141001b", "parentComponentId": null }, { "bbox": { "h": 0.03, "w": 0.3, "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:37.582+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "0807cd51-dd68-4f0f-ac13-fe89b76d28df", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [ { "matchId": "bd51fa38-3a6f-4712-9c07-267a69dc5570", "evidence": "The slide explicitly frames the content as 'smoking gun information' to expose unethical/fraudulent practices.", "framework": null, "confidence": 0.9, "extraction": { "at": "2026-05-02 20:12:37.582+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 234, "frameworkName": "fraud-exposure" } ], "arcBeats": [], "loops": [], "locked": true }, { "page": 235, "type": "tension", "title": "The slide uses a Q&A format to highlight potential ethical concerns regarding data transparency in organ recovery.", "function": "expose_contradiction", "rawType": "expose_contradiction", "block": null, "metadata": { "slideType": "expose_contradiction", "slideTypeCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-124c-75aa-984a-0a3d0d8fc8df", "version": 1, "description": null }, "function": "expose_contradiction", "functionCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-171f-776f-887c-73edaff4cf9c", "version": 1, "description": null }, "density": "balanced", "densityScore": 46, "componentCount": 5, "textChars": 2225, "nDataPoints": 0, "notes": "The slide uses a Q&A format to highlight potential ethical concerns regarding data transparency in organ recovery.", "elementsJson": [ "paragraph", "quote_block", "footnote" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:12:37.783+00", "seconds": 3.339, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/235", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-235", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "I kept having really weird things happen, like I kept going out with brand-new surgeons and they were taking a really long time, so I was just paranoid about it.", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:17+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a984-83c0d7b0974d", "parentComponentId": null }, { "bbox": { "h": 0.45, "w": 0.86, "x": 0.07, "y": 0.45 }, "kind": "list", "text": "OCS Specialist didn't trust TransMedics to tell the truth to recipient centers about ischemic times and organ quality/damage\nQ: “When they would then call around and tell people we have an organ, were they honest in it took 45 minutes or two hours or whatever to recover a liver? Or were they just saying we have an organ, and they didn't want it, and they wouldn't tell you more?”\nA: “I never really 100% trusted that they were, so I always made sure to get exact times so the centers could make their own decision based on the numbers.”\nQ: “So, you were worried enough that TransMedics was not telling the transplant center everything they need to know about the organ while pawning it off, so you made sure that you did that.”\nA: “I just wanted everyone to have the right information.”\nQ: “Was there a time when you decided to overcompensate and do that where they should have said something and didn't?”\nA: “I kept having really weird things happen, like I kept going out with brand-new surgeons and they were taking a really long time, so I was just paranoid about it.” - Former TransMedics OCS specialist", "attrs": null, "canon": { "kind": { "name": "List", "slug": "list", "status": "active", "canonId": "019de52c-f94b-779b-a53b-fd4904a5f4d2", "version": 1, "description": "Bullet or numbered list." }, "tool": null, "subkind": { "name": "Bullet list", "slug": "bullet", "status": "active", "canonId": "019de52c-fc98-7169-a083-5cab805076ca", "version": 1, "description": null }, "framework": null }, "subkind": "bullet", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:37.783+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "63a5ea88-dd43-4354-8cb7-19b61fa21546", "parentComponentId": null }, { "bbox": { "h": 0.35, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "paragraph", "text": "The ex-OCS Specialist expressed concern as to whether TransMedics lied to receiving centers when organs had experienced long ischemic times – perhaps the single most important criteria in assessing the viability of a DCD organ. We asked if the company was honest in conveying the duration of ischemic time: “I never really 100% trusted they are, so I always made sure to get the exact times so the centers could make their own decision based on the numbers.” We then asked if the ex-technician had to overcompensate and convey the info independently because TransMedics did not: “I just wanted everyone to have the right information”; “I kept having really weird things happen...so I was just paranoid about it.”", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:37.783+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "24d437b2-1c74-46f7-a4d8-a01ac8a1104f", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "I never really 100% trusted they were, so I always made sure to get the exact times so the centers could make their own decision based on the numbers. — Former TransMedics OCS specialist", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:17+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a984-8795eba27e44", "parentComponentId": null }, { "bbox": { "h": 0.03, "w": 0.3, "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:37.783+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "fa681774-ee23-42ad-aadb-af2f3de00cd1", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [ { "matchId": "c86870f9-5e80-46b8-8137-7fdd542ab7df", "evidence": "The slide presents expert testimony to allege deceptive practices by the company.", "framework": null, "confidence": 0.9, "extraction": { "at": "2026-05-02 20:12:37.783+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 235, "frameworkName": "fraud-exposure" } ], "arcBeats": [], "loops": [], "locked": true }, { "page": 236, "type": "tension", "title": "The slide uses a Q&A transcript format to support the primary allegation of unethical organ procurement practices.", "function": "expose_contradiction", "rawType": "expose_contradiction", "block": null, "metadata": { "slideType": "expose_contradiction", "slideTypeCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-124c-75aa-984a-0a3d0d8fc8df", "version": 1, "description": null }, "function": "expose_contradiction", "functionCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-171f-776f-887c-73edaff4cf9c", "version": 1, "description": null }, "density": "dense", "densityScore": 56, "componentCount": 6, "textChars": 3445, "nDataPoints": 0, "notes": "The slide uses a Q&A transcript format to support the primary allegation of unethical organ procurement practices.", "elementsJson": [ "paragraph", "quote_block", "footnote" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:12:38.809+00", "seconds": 4.339, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/236", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-236", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": { "h": 0.05, "w": 0.86, "x": 0.07, "y": 0.55 }, "kind": "callout", "text": "Organs rejected due to long warm ischemic times or pathology but still allegedly steered to aggressive TransMedics users", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": null, "subkind": { "name": "Primary callout", "slug": "primary", "status": "active", "canonId": "019de52c-fbd1-70eb-a9ce-8997f8674c1d", "version": 1, "description": null }, "framework": null }, "subkind": "primary", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:38.809+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "3db0569b-1f9b-4e52-b5c7-96c2d68bfd56", "parentComponentId": null }, { "bbox": null, "kind": "callout", "text": "The ex-employee expressed “shock” that anyone took these organs: “I’ve had a lot of organs that were refused by the initial center...’We actually don’t want it’...that usually boiled down to withdrawal time...or the pathology results”.", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:19+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a986-2c1eafe5e22e", "parentComponentId": null }, { "bbox": { "h": 0.45, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "paragraph", "text": "The ex-OCS Specialist stated that organs were damaged and often refused by the first center on the match list, because of long ischemic times due to surgeon incompetence, or were diseased – and that TransMedics would then start shopping them aggressively to other centers. The ex-employee expressed “shock” that anyone took these organs: “I’ve had a lot of organs that were refused by the initial center...’We actually don’t want it’...that usually boiled down to withdrawal time...or the pathology results”; “when those more conservative centers...refuse it...it’s supposed to go to who’s next on the list...and that’s when those phone calls in the background were happening”; “I’ve seen organs that I was very surprised that anybody wanted...I’d look at some of these histories”; “they were drinking a fifth of liquor a day, and you’d be like, ‘Wow, I can’t believe that anybody wants this liver...stuff where you’re just shocked...I was shocked to learn this is what was happening or an overdose was being transplanted...”", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:38.809+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "0f544fe4-2d31-4383-a183-42760a2957de", "parentComponentId": null }, { "bbox": { "h": 0.35, "w": 0.86, "x": 0.07, "y": 0.6 }, "kind": "paragraph", "text": "A: “I’ve had a lot of organs that were refused by the initial center that called in the request for service. This happened a lot where they were like, “We actually don’t want it.” But that usually boiled down to withdrawal time as a DCD - or the pathology results. Most of the time, they were refused because of the withdrawal time - the time limit exceeded the policy for that transplant center.” Q: “But you’re saying in those cases, TransMedics would find somebody to take the organ anyway?” A: “So, when those more conservative centers are the ones who initially were supposed to get the organ, and they refuse it, it’s supposed to go to who’s next on the list. And that’s when those phone calls in the background were happening. Q: “Of the aggressive transplant centers, did you ever see them turn down an organ or they would literally take any organ? A: “I’ve seen organs that I was very surprised that anybody wanted.” Q: “What happened there about the organ? You and the other team could have been like, “Wow. What the hell just happened?” What made you surprised that somebody took it?” A: “It was a combination of things. But it usually boiled down to what the actual history was. And so, I was sometimes surprised that an alcoholic liver was going to be transplanted into somebody else...I’d look at some of these histories, and they’d say that they were drinking a fifth of liquor a day, and you’d be like, “Wow. I can’t believe that anybody wants this liver.” It was like stuff like that where you’re just kind of shocked, or at least I was shocked to learn this is what was happening or an overdose was being transplanted. Those were always surprising to me...” - Former TransMedics OCS specialist", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:38.809+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "7dbdaccf-7fcd-4952-8869-41ce0eccc68e", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "“I’ve had a lot of organs that were refused by the initial center that called in the request for service. This happened a lot where they were like, ‘We actually don’t want it.’ But that usually boiled down to withdrawal time as a DCD - or the pathology results.” — Former TransMedics OCS specialist", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:19+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a986-31d63200e231", "parentComponentId": null }, { "bbox": { "h": 0.03, "w": 0.3, "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:38.809+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "34a3eead-7c4b-48da-b2cf-a280bef72ba2", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [], "arcBeats": [], "loops": [], "locked": true }, { "page": 237, "type": "tension", "title": "The slide uses a quote-heavy structure to build a narrative of corporate negligence regarding medical standards.", "function": "expose_contradiction", "rawType": "expose_contradiction", "block": null, "metadata": { "slideType": "expose_contradiction", "slideTypeCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-124c-75aa-984a-0a3d0d8fc8df", "version": 1, "description": null }, "function": "expose_contradiction", "functionCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-171f-776f-887c-73edaff4cf9c", "version": 1, "description": null }, "density": "balanced", "densityScore": 48, "componentCount": 5, "textChars": 2687, "nDataPoints": 0, "notes": "The slide uses a quote-heavy structure to build a narrative of corporate negligence regarding medical standards.", "elementsJson": [ "paragraph", "callout_box", "footnote" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:12:37.844+00", "seconds": 3.245, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/237", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-237", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "They always wanted to get people to accept the organ right away, and that is what it boiled down to. Get it on the machine, and everything else was questionable where they’re like, it kind of looks okay, but I want to see how it does.", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:18+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a984-d1f7d8aa0f32", "parentComponentId": null }, { "bbox": { "h": 0.45, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "paragraph", "text": "The ex-OCS Specialist stated every single organ was ultimately accepted and that “I never had a turn down,” no matter what the pump indicated for lactase, bile, or other biomarkers of viability – unsurprising, as TransMedics allegedly goes down its list of its aggressive customers until it finds one rapacious enough – perhaps Mayo Arizona, Houston Methodist, or Henry Ford – to transplant what more responsible centers won’t touch. The color is consistent with what we heard from surgeons who are high-volume users of the device and NOP service – that they have never seen TransMedics say “thumbs down” on an organ they went to retrieve. The specialist stated “they always wanted people to get people to accept the organ right away, and that is what it boiled down to...get it on the machine, and everything else was questionable...I never had a turn-down...I had thought that maybe people wouldn’t want my liver because it wasn’t putting much bile out, but they were like, no, we’re actually happy with this.”", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:37.844+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "278ae750-aae8-4e88-9d68-ebc634aa9668", "parentComponentId": null }, { "bbox": { "h": 0.35, "w": 0.86, "x": 0.07, "y": 0.55 }, "kind": "quote", "text": "OCS specialist never saw an organ turned down, even defective ones; surprised the organs were accepted. “They always wanted to get people to accept the organ right away, and that is what it boiled down to. Get it on the machine, and everything else was questionable where they’re like, it kind of looks okay, but I want to see how it does. That happened a lot where they were like, “It looks fine, but I want to see how it performs.” And they could turn it down based on that. So, they wanted to check the lactase and if it was putting bile out. But I never had a turn-down. Everybody ended up being like, okay, yeah, this is good enough, “Okay, we’ll take it.” There were a couple of times where I had thought that maybe they wouldn’t want my liver because it wasn’t putting much bile out, but they were like, no, we’re actually happy with this.” - Former TransMedics OCS specialist", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:37.844+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "022cf6ad-d9a8-4786-9c4f-79e78a2b594a", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "“I never had a turn down,” no matter what the pump indicated for lactase, bile, or other biomarkers of viability... “they always wanted people to get people to accept the organ right away, and that is what it boiled down to...get it on the machine, and everything else was questionable...I never had a turn-down...I had thought that maybe people wouldn't want my liver because it wasn't putting much bile out, but they were like, no, we're actually happy with this.” — Former TransMedics OCS specialist", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:18+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a984-d578abcb3595", "parentComponentId": null }, { "bbox": { "h": 0.02, "w": 0.3, "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:37.844+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "e933b3a0-1235-40c1-8578-6f04e757b6aa", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [], "arcBeats": [], "loops": [], "locked": true }, { "page": 238, "type": "tension", "title": "The slide uses direct quotes from former employees to support the claim of incompetence and lack of proper medical oversight.", "function": "expose_contradiction", "rawType": "expose_contradiction", "block": null, "metadata": { "slideType": "expose_contradiction", "slideTypeCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-124c-75aa-984a-0a3d0d8fc8df", "version": 1, "description": null }, "function": "expose_contradiction", "functionCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-171f-776f-887c-73edaff4cf9c", "version": 1, "description": null }, "density": "dense", "densityScore": 61, "componentCount": 7, "textChars": 2530, "nDataPoints": 0, "notes": "The slide uses direct quotes from former employees to support the claim of incompetence and lack of proper medical oversight.", "elementsJson": [ "paragraph", "quote_block", "footnote" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:12:37.957+00", "seconds": 3.335, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/238", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-238", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": { "x": 0.07, "y": 0.58 }, "kind": "callout", "text": "“Clinical leads” in control of procurements are untrained OCS Specialists who got promoted", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": null, "subkind": { "name": "Primary callout", "slug": "primary", "status": "active", "canonId": "019de52c-fbd1-70eb-a9ce-8997f8674c1d", "version": 1, "description": null }, "framework": null }, "subkind": "primary", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:37.957+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "810213ce-6d70-4806-ab1a-18aa55a8cfe9", "parentComponentId": null }, { "bbox": null, "kind": "callout", "text": "The technicians tend to be inexperienced and incompetent, not to mention unlicensed to practice medicine, and allegedly receive only one week of training before being handed organs to manage.", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:18+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a985-5d4dbbdba0ba", "parentComponentId": null }, { "bbox": { "x": 0.07, "y": 0.07 }, "kind": "paragraph", "text": "We suspect another reason why organs retrieved by TransMedics seem to find a taker, no matter how diseased the patient or damaged the organ, is that the retrieval surgeon and OCS Specialist monitoring the organ on the pump are allegedly directed by case coordinators and prevented from communicating directly with the receiving center.", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:37.957+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "10c03c75-5dd7-49aa-8467-338fda8fcad0", "parentComponentId": null }, { "bbox": { "x": 0.07, "y": 0.26 }, "kind": "paragraph", "text": "An ex-procurement surgeon we quoted earlier stated “all communication goes through the TransMedics people.” The ex-OCS Specialist stated the same, and noted that these case managers are simply device technicians who were moved to support. As we detail in the next section, the technicians tend to be inexperienced and incompetent, not to mention unlicensed to practice medicine, and allegedly receive only one week of training before being handed organs to manage: “I always had to report everything to whoever my clinical lead was that day...everything had to be like, take a picture or video and send it to whoever was running the case remotely”; “they did my job...they were me until they got promoted or asked to start doing some support.”", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:37.957+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "54bdffbb-1549-44b8-9a63-5c14660d6135", "parentComponentId": null }, { "bbox": { "x": 0.07, "y": 0.62 }, "kind": "quote", "text": "Q: “Who was monitoring and making adjustments to the organ? Was that you, or was that the surgeon, the recipient surgeon, or did you have full ownership of monitoring the health of the organ?”\nA: “It was me, but I always had to report everything to whoever my clinical lead was that day. So, it was like I was actually physically adjusting things, but everything had to be like, take a picture or a video and send it to whoever was running the case remotely.”\nQ: “And who were these clinical leads? These were people based in Boston? Who were these clinical leads, and what do they do?\nA: “They did my job. They were me until they got promoted or asked to start doing some support.” - Former TransMedics OCS specialist", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:37.957+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "2174f13a-9719-428c-aecc-d7dfc41f0a30", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "\"all communication goes through the TransMedics people.\" — Ex-procurement surgeon; \"I always had to report everything to whoever my clinical lead was that day...everything had to be like, take a picture or video and send it to whoever was running the case remotely\"; \"they did my job...they were me until they got promoted or asked to start doing some support.\" — Former TransMedics OCS specialist", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:18+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a985-61dc6549a371", "parentComponentId": null }, { "bbox": { "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:37.957+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "74324274-bb34-4498-ac8b-ba8b20f5574b", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [ { "matchId": "d4ca22e6-fd98-48e3-93ad-4dbc4d5315a3", "evidence": "The slide explicitly aims to expose alleged incompetence and lack of medical licensing in a clinical process.", "framework": null, "confidence": 0.9, "extraction": { "at": "2026-05-02 20:12:37.957+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 238, "frameworkName": "fraud-exposure" } ], "arcBeats": [], "loops": [], "locked": true }, { "page": 239, "type": "tension", "title": "The slide uses direct quotes to build a narrative of negligence and poor surgical technique.", "function": "name_villain", "rawType": "villain_critique", "block": null, "metadata": { "slideType": "villain_critique", "slideTypeCanon": { "name": "Villain critique", "slug": "villain_critique", "status": "active", "canonId": "019de52d-10bc-7136-bf20-09de59d17447", "version": 1, "description": null }, "function": "name_villain", "functionCanon": { "name": "Name villain", "slug": "name_villain", "status": "active", "canonId": "019de52d-1746-70d6-bc58-5eeaf5865526", "version": 1, "description": null }, "density": "dense", "densityScore": 72, "componentCount": 8, "textChars": 3215, "nDataPoints": 0, "notes": "The slide uses direct quotes to build a narrative of negligence and poor surgical technique.", "elementsJson": [ "paragraph", "quote_block", "footnote" ], "confidence": 0.95, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:12:38.736+00", "seconds": 4.077, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/239", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-239", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": { "h": 0.05, "w": 0.86, "x": 0.07, "y": 0.58 }, "kind": "callout", "text": "NOP surgeon incompetence leads to unusable organs, that TransMedics keeps trying to pawn to one center after", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": null, "subkind": { "name": "Primary callout", "slug": "primary", "status": "active", "canonId": "019de52c-fbd1-70eb-a9ce-8997f8674c1d", "version": 1, "description": null }, "framework": null }, "subkind": "primary", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:38.736+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "6e953390-5065-4a7d-b0a5-272d5e10a1cd", "parentComponentId": null }, { "bbox": { "h": 0.03, "w": 0.86, "x": 0.07, "y": 0.76 }, "kind": "callout", "text": "Can't get any organ procured in time – whether heart, liver or lungs – \"just crazy\"", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": null, "subkind": { "name": "Primary callout", "slug": "primary", "status": "active", "canonId": "019de52c-fbd1-70eb-a9ce-8997f8674c1d", "version": 1, "description": null }, "framework": null }, "subkind": "primary", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:38.736+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "d2cf15c1-922b-4e50-9f3a-5de179d80f16", "parentComponentId": null }, { "bbox": { "h": 0.15, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "paragraph", "text": "In addition to OCS Specialists who worked side-by-side with TransMedics NOP surgeons during organ recoveries, we spoke with organ procurement technicians at other hospitals who were also frequently in OR’s – who stated that they witnessed TransMedics aggressively trying to pawn unusable organs.", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:38.736+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "44412ddd-1876-4ec6-8b0b-5ae93dc3a9db", "parentComponentId": null }, { "bbox": { "h": 0.25, "w": 0.86, "x": 0.07, "y": 0.22 }, "kind": "paragraph", "text": "An experienced retrieval technician, who does runs for a leading academic transplant center and has numerous colleagues inside TransMedics, echoed that their surgeons lack the skills to procure organs within the 20-30 minute limit for warm ischemic time, beyond which organs deteriorate – \"it's rare to see one that does it smoothly; \"they're still struggling with the heart...20 minutes from cross-clamp...and I'm like, 'Whoa, that's just crazy...it's just crazy\"; \"it extends the warm ischemia time.\" Yet, the technician witnessed persistent efforts to push such suspect organs – \"I often leave, and I'm like, 'There's no way they're going to be able to use that organ....they just keep going and going and going, keep trying and trying and trying...hours and hours later when the heart function is off....\"", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:38.736+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "48011e49-ebbc-424b-b994-542b40784d80", "parentComponentId": null }, { "bbox": { "h": 0.12, "w": 0.86, "x": 0.07, "y": 0.63 }, "kind": "quote", "text": "Q: \"Have you seen an organ be jeopardized or not be usable because of this incompetence? It sounds like they don't really care. They'll just pawn it off to one of their high-volume TransMedics users where they're just looking for volume for the transplant center.\" A: \"I often leave, and I'm like, 'There's no way they're going to be able to use that organ'...I feel like they just keep going and going and going, keep trying and trying and trying...it's going to be in an operating room with a recipient hours and hours later when the heart function is off.\" – Organ procurement technician at a high-volume Northwest academic transplant center", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:38.736+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "10f3fa24-ab16-4a8d-811a-8b3bf9c14bec", "parentComponentId": null }, { "bbox": { "h": 0.16, "w": 0.86, "x": 0.07, "y": 0.79 }, "kind": "quote", "text": "\"Typically, the heart is the first thing out the door and it's on its way. They're still struggling with the heart. The goal with the heart when you're not doing TransMedics is to have it packaged and out the door within 20 minutes from cross-clamp [..] and I'm like, \"Whoa, that's just crazy. The heart's still in the room and the lungs. The kidneys and the liver are already out of the patient. It's just crazy [..] Yeah, they're on the back table for a long time, so when the organ comes out, and there's no blood flow,, they bring them onto the back table, and they have to do 35 different things before they can get it on the pump and then start to troubleshoot [..] So, it extends the warm ischemia time on the back table for the organ, which is not ideal.\" – Organ procurement technician at a high-volume Northwest academic transplant center", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:38.736+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "e4159f19-e577-49fa-97e2-5b178a9505ab", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "“I often leave, and I’m like, ‘There’s no way they’re going to be able to use that organ’…I feel like they just keep going and going and going, keep trying and trying and trying…it’s going to be in an operating room with a recipient hours and hours later when the heart function is off.” — Organ procurement technician at a high-volume Northwest academic transplant center", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:18+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a985-911c9b437ab0", "parentComponentId": null }, { "bbox": { "h": 0.02, "w": 0.3, "x": 0.07, "y": 0.96 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:38.736+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "7df0b348-7443-485f-bab1-aeeaf94bf95a", "parentComponentId": null } ], "metrics": [], "tools": [ { "tool": { "name": "Anadiplosis", "slug": "anadiplosis", "status": "active", "bestFor": null, "canonId": "019dd956-a0a5-75f9-a98c-7b7d8ee377a1", "version": 1, "bodyDocId": null, "description": "Ending one clause with a word that begins the next", "familyLabel": null, "categoryName": "Loop", "categorySlug": "loop" }, "agent": "Storyteller", "layer": "slide", "agents": [ "Storyteller" ], "matchId": "1c5ea8ed-308f-41e1-82f4-941740faf37b", "evidence": "The use of repeated phrases and testimonials from experts creates an anadiplosis effect, emphasizing the severity of the issue.", "pageRefs": null, "priority": null, "whenToUse": null, "confidence": 0.7, "extraction": { "at": "2026-07-17 03:28:52.230168+00", "model": "or:meta-llama/llama-4-scout", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 239, "whyItWorks": null, "antipattern": null, "cardinality": null, "narrativePurpose": null }, { "tool": { "name": "Villain slide", "slug": "villain-slide", "status": "active", "bestFor": "In activist decks where the personality matters", "canonId": "019dd9e1-518c-7404-976a-5be5a517b659", "version": 1, "bodyDocId": null, "description": "A dedicated slide presenting the named villain visually", "familyLabel": null, "categoryName": null, "categorySlug": null }, "agent": null, "layer": "slide", "agents": null, "matchId": "b36e7e3f-89dd-49ef-9847-a679f2011c0e", "evidence": "The slide presents a critical view of TransMedics, highlighting the incompetence of OCS Specialists and the risks they pose to organ procurement and transplantation.", "pageRefs": null, "priority": null, "whenToUse": "In activist decks where the personality matters", "confidence": 0.9, "extraction": { "at": "2026-07-17 03:28:52.191272+00", "model": "or:meta-llama/llama-4-scout", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 239, "whyItWorks": "Makes the antagonist concrete", "antipattern": null, "cardinality": null, "narrativePurpose": null } ], "frameworks": [], "arcBeats": [], "loops": [], "locked": true }, { "page": 240, "type": "tension", "title": "This is part of a series of critical research notes (Part 9).", "function": "name_villain", "rawType": "villain_critique", "block": null, "metadata": { "slideType": "villain_critique", "slideTypeCanon": { "name": "Villain critique", "slug": "villain_critique", "status": "active", "canonId": "019de52d-10bc-7136-bf20-09de59d17447", "version": 1, "description": null }, "function": "name_villain", "functionCanon": { "name": "Name villain", "slug": "name_villain", "status": "active", "canonId": "019de52d-1746-70d6-bc58-5eeaf5865526", "version": 1, "description": null }, "density": "sparse", "densityScore": 13, "componentCount": 3, "textChars": 501, "nDataPoints": 0, "notes": "This is part of a series of critical research notes (Part 9).", "elementsJson": [ "paragraph" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:12:37.018+00", "seconds": 2.08, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/240", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-240", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "Part 9. Organs on TransMedics devices are managed by inexperienced, high-risk technicians called OCS Specialists, who allegedly receive only a week of training prior to engaging in the practice of medicine, putting organs and recipients in jeopardy.", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:17+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a984-99d9a48e9722", "parentComponentId": null }, { "bbox": { "h": 0.028, "w": 0.021, "x": 0.896, "y": 0.954 }, "kind": "other", "text": "240", "attrs": null, "canon": { "kind": { "name": "Other", "slug": "other", "status": "active", "canonId": "019de52c-fa90-743c-8bf6-20d1fbe82b6d", "version": 1, "description": "Fallback when no canonical kind applies." }, "tool": null, "subkind": { "name": "Unclassified", "slug": "unclassified", "status": "active", "canonId": "019de52d-05ca-77db-81fb-db7d4234bbc0", "version": 1, "description": null }, "framework": null }, "subkind": "unclassified", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:37.018+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "324af872-4846-46f5-bed7-392f51ff4a45", "parentComponentId": null }, { "bbox": { "h": 0.188, "w": 0.854, "x": 0.073, "y": 0.069 }, "kind": "paragraph", "text": "Part 9. Organs on TransMedics devices are managed by inexperienced, high-risk technicians called OCS Specialists, who allegedly receive only a week of training prior to engaging in the practice of medicine, putting organs and recipients in jeopardy.", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:37.018+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "236233ca-6d7a-4192-8473-285661cff205", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [], "arcBeats": [], "loops": [], "locked": true }, { "page": 241, "type": "tension", "title": "The slide uses a quote from Congressman Paul Gosar to substantiate claims of a 'bait and switch' business model.", "function": "name_villain", "rawType": "villain_critique", "block": null, "metadata": { "slideType": "villain_critique", "slideTypeCanon": { "name": "Villain critique", "slug": "villain_critique", "status": "active", "canonId": "019de52d-10bc-7136-bf20-09de59d17447", "version": 1, "description": null }, "function": "name_villain", "functionCanon": { "name": "Name villain", "slug": "name_villain", "status": "active", "canonId": "019de52d-1746-70d6-bc58-5eeaf5865526", "version": 1, "description": null }, "density": "sparse", "densityScore": 24, "componentCount": 4, "textChars": 643, "nDataPoints": 2, "notes": "The slide uses a quote from Congressman Paul Gosar to substantiate claims of a 'bait and switch' business model.", "elementsJson": [ "paragraph", "quote_block", "footnote" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:12:38.268+00", "seconds": 3.283, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/241", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-241", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": { "h": 0.35, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "paragraph", "text": "As part of its National OCS Program (NOP), TransMedics pumps are operated by technicians called OCS Specialists who are patently incapable and unqualified to do so...", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:38.268+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "12cc7cf4-e8f4-4eac-85f5-4d874fc1ee24", "parentComponentId": null }, { "bbox": { "h": 0.38, "w": 0.86, "x": 0.07, "y": 0.49 }, "kind": "quote", "text": "Once FDA approval was achieved, TransMedics began to change the entirety of its business model. Transplant centers that participated in the trial and previously purchased the equipment were then mandated by TransMedics to utilize the OCS...", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Pull quote", "slug": "pull-quote", "status": "active", "canonId": "019de52c-fbf9-76fe-97e1-a0b7540445c9", "version": 1, "description": null }, "framework": null }, "subkind": "pull-quote", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:38.268+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "4d7afb20-6926-4458-b124-0e860033c48f", "parentComponentId": null }, { "bbox": { "h": 0.03, "w": 0.75, "x": 0.07, "y": 0.91 }, "kind": "source-note", "text": "Source: https://dailycaller.com/2024/02/22/exclusive-paul-gosar-transmedics-lifesaving-medical-devices-hostage-oversight-ocs/; Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:38.268+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "c05a2f7d-d4cd-4fc8-a6e5-4be14faaa82f", "parentComponentId": null }, { "bbox": { "h": 0.03, "w": 0.45, "x": 0.07, "y": 0.45 }, "kind": "title", "text": "Congressman Paul Gosar letter to TransMedics CEO, Feb 21, 2024", "attrs": null, "canon": { "kind": { "name": "Title", "slug": "title", "status": "active", "canonId": "019de52c-f7dd-76d9-b848-b1f12bd85cf4", "version": 1, "description": "Slide title or headline." }, "tool": null, "subkind": { "name": "Headline", "slug": "headline", "status": "active", "canonId": "019de52c-fae1-7463-9a7c-d60668eced0d", "version": 1, "description": null }, "framework": null }, "subkind": "headline", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:38.268+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "f41c14ca-278c-4b2c-885e-719820d2918e", "parentComponentId": null } ], "metrics": [], "tools": [ { "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null, "categoryName": null, "categorySlug": null }, "agent": null, "layer": "slide", "agents": null, "matchId": "20b4015e-f704-432d-bbaf-1d9d72830cbc", "evidence": "The inclusion of a quote from Congressman Paul Gosar adds credibility to the critique.", "pageRefs": null, "priority": null, "whenToUse": null, "confidence": 0.7, "extraction": { "at": "2026-07-17 03:28:52.349836+00", "model": "or:meta-llama/llama-4-scout", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 241, "whyItWorks": null, "antipattern": null, "cardinality": "common", "narrativePurpose": null } ], "frameworks": [ { "matchId": "67d1f653-32d9-4d3b-b6d9-c1dc49dc23c7", "evidence": "The slide frames TransMedics as a negligent actor using a 'bait and switch' scheme.", "framework": null, "confidence": 0.9, "extraction": { "at": "2026-05-02 20:12:38.268+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 241, "frameworkName": "antagonist-introduction" } ], "arcBeats": [], "loops": [], "locked": true }, { "page": 242, "type": "tension", "title": "The slide uses a quote-based argument to challenge the company's stated quality control rationale.", "function": "expose_contradiction", "rawType": "expose_contradiction", "block": null, "metadata": { "slideType": "expose_contradiction", "slideTypeCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-124c-75aa-984a-0a3d0d8fc8df", "version": 1, "description": null }, "function": "expose_contradiction", "functionCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-171f-776f-887c-73edaff4cf9c", "version": 1, "description": null }, "density": "balanced", "densityScore": 47, "componentCount": 5, "textChars": 2478, "nDataPoints": 0, "notes": "The slide uses a quote-based argument to challenge the company's stated quality control rationale.", "elementsJson": [ "paragraph", "quote_block" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:12:38.358+00", "seconds": 3.318, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/242", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-242", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": { "h": 0.05, "w": 0.86, "x": 0.07, "y": 0.58 }, "kind": "callout", "text": "Device technicians are unqualified and “unprepared”; require help; “not qualified to be pulling or pushing medications”", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": null, "subkind": { "name": "Primary callout", "slug": "primary", "status": "active", "canonId": "019de52c-fbd1-70eb-a9ce-8997f8674c1d", "version": 1, "description": null }, "framework": null }, "subkind": "primary", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:38.358+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "5282798b-afe9-4f8d-9725-d1f8a04c75d9", "parentComponentId": null }, { "bbox": { "h": 0.35, "w": 0.86, "x": 0.07, "y": 0.15 }, "kind": "paragraph", "text": "We begin with an experienced retrieval technician, who does runs for a leading academic transplant center and works side-by-side with TransMedics OCS Specialists and surgeons inside OR’s, and who has colleagues at the company. The color was devastating – and entirely consistent with what former OCS Specialists admitted to us themselves: “...just how unqualified the people are that are running their devices...those should be nurses...they’re not even people from the operating room, which puts everybody in a pinch....these people are coming in and they don’t know...the other teams...have to help them...they’re clearly not prepared...one of my co-workers who is not qualified in any way, shape, or form...she’s still working for TransMedics...she’s not qualified to be pulling or pushing medications.”", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:38.358+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "db1755b6-0d7c-4948-bf17-fb8e1f6eb138", "parentComponentId": null }, { "bbox": { "h": 0.25, "w": 0.86, "x": 0.07, "y": 0.63 }, "kind": "quote", "text": "Q: “You had a lot of interesting anecdotes – any others?”\nA: “Just how unqualified the people are that are running their devices. Those should be nurses running those devices and they’re not always nurses. A lot of times, they’re not even people from the operating room, which puts everybody else in a pinch that is used to working in operating rooms. There’s a culture and way that you do things in an operating room, and these people are coming in, and they don’t know, and then that takes away from the other teams because they have to help them, and they have to explain to them that you can’t do this, you can’t do that. They’re clearly not prepared to come in. One of my co-workers who is not qualified in any way, shape, or form to work for TransMedics, and she’s still working for TransMedics. She’s not qualified to be pulling or pushing medications.” - Organ procurement technician at a high volume Northwest academic transplant center", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:38.358+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "95923547-007f-4890-beeb-540098e3da4f", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "“...just how unqualified the people are that are running their devices...those should be nurses...they’re not even people from the operating room, which puts everybody in a pinch....these people are coming in and they don’t know...the other teams...have to help them...they’re clearly not prepared...one of my co-workers who is not qualified in any way, shape, or form...she’s still working for TransMedics...she’s not qualified to be pulling or pushing medications.” — Organ procurement technician at a high volume Northwest academic transplant center", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:18+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a985-1c8d39647215", "parentComponentId": null }, { "bbox": { "h": 0.02, "w": 0.25, "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:38.358+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "8ab6d838-39e6-48ba-9561-7ca497ad5fa5", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [ { "matchId": "81a9ca0d-0f28-4c11-848a-f6fa98991b89", "evidence": "The slide explicitly frames the company's claim as a 'disingenuous ruse' and uses expert testimony to contradict it.", "framework": null, "confidence": 0.9, "extraction": { "at": "2026-05-02 20:12:38.358+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 242, "frameworkName": "fraud-exposure" } ], "arcBeats": [], "loops": [], "locked": true }, { "page": 243, "type": "tension", "title": "The slide uses direct quotes to highlight operational failures and lack of training in the field.", "function": "expose_contradiction", "rawType": "testimonial", "block": null, "metadata": { "slideType": "testimonial", "slideTypeCanon": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52d-0a2d-7782-8a48-7e84df92cc97", "version": 1, "description": null }, "function": "expose_contradiction", "functionCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-171f-776f-887c-73edaff4cf9c", "version": 1, "description": null }, "density": "balanced", "densityScore": 43, "componentCount": 6, "textChars": 1305, "nDataPoints": 0, "notes": "The slide uses direct quotes to highlight operational failures and lack of training in the field.", "elementsJson": [ "paragraph", "quote_block", "footnote" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:12:38.791+00", "seconds": 3.512, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/243", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-243", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "it just blows my mind that they’re hiring people who are not qualified...I see them struggle...I talk to the people that run their devices...I’m standing next to them when they’re stressing and sweating and freaking out and not knowing what to do and calling support lines and trying to pull things up on iPads...I’ve stepped in several times to help them...when they can’t pull it together", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:18+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a985-a42882566f4f", "parentComponentId": null }, { "bbox": { "h": 0.35, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "paragraph", "text": "The procurement technician emphasized the importance of the role as it is essentially the practice of medicine with the organ going into a living recipient, and expressed shock at the level of incompetence...", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:38.791+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "16711c07-2861-43ca-86ed-7aaf8c8ac7ed", "parentComponentId": null }, { "bbox": { "h": 0.25, "w": 0.86, "x": 0.07, "y": 0.45 }, "kind": "quote", "text": "\"Blows my minds\" that technicians are so unqualified; struggling, scrambling, and stressed while trying to operate the device...", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:38.791+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "464e4516-7596-4e7d-bc09-3767a700962c", "parentComponentId": null }, { "bbox": { "h": 0.18, "w": 0.86, "x": 0.07, "y": 0.75 }, "kind": "quote", "text": "\"Majority\" of technicians have allegedly never been \"inside an operating room\" - \"complete nightmare every time\"...", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:38.791+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "b60cb1f6-b69c-4268-9eec-ba1b86fd1ed4", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "“I understand it’s not a human, but it’s an organ that’s going to go into a live human. It just blows my mind that they’re hiring people who are not qualified to be doing the stuff that they’re doing... they’re scrambling and can’t do it... these poor people are just stressed beyond words and have had a week of training.” — Organ procurement technician at a high-volume Northwest academic transplant center", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:18+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a985-a9af04f1dad7", "parentComponentId": null }, { "bbox": { "h": 0.03, "w": 0.3, "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:38.791+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "f7c87f22-36df-4d39-a250-b992eab581f9", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [], "arcBeats": [], "loops": [], "locked": true }, { "page": 244, "type": "analysis", "title": "The slide uses a narrative structure to expose operational risks and employee dissatisfaction.", "function": "diagnose_problem", "rawType": "testimonial", "block": null, "metadata": { "slideType": "testimonial", "slideTypeCanon": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52d-0a2d-7782-8a48-7e84df92cc97", "version": 1, "description": null }, "function": "diagnose_problem", "functionCanon": { "name": "Diagnose problem", "slug": "diagnose_problem", "status": "active", "canonId": "019de52d-176d-761f-b608-cf52262d2ab2", "version": 1, "description": null }, "density": "balanced", "densityScore": 46, "componentCount": 6, "textChars": 1538, "nDataPoints": 0, "notes": "The slide uses a narrative structure to expose operational risks and employee dissatisfaction.", "elementsJson": [ "paragraph", "footnote" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:12:38.102+00", "seconds": 2.637, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/244", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-244", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "It's like you're basically being asked to engage in the practice of medicine after a week's worth of training.", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:18+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a984-e89a639c613e", "parentComponentId": null }, { "bbox": { "h": 0.25, "w": 0.86, "x": 0.07, "y": 0.62 }, "kind": "list", "text": "OCS Specialists quit because “stressed out”; “terrifying” situation; feel untrained; on their own and “calling for help”", "attrs": null, "canon": { "kind": { "name": "List", "slug": "list", "status": "active", "canonId": "019de52c-f94b-779b-a53b-fd4904a5f4d2", "version": 1, "description": "Bullet or numbered list." }, "tool": null, "subkind": { "name": "Bullet list", "slug": "bullet", "status": "active", "canonId": "019de52c-fc98-7169-a083-5cab805076ca", "version": 1, "description": null }, "framework": null }, "subkind": "bullet", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:38.102+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "56ea9377-dfe2-40ce-9678-677fb158c246", "parentComponentId": null }, { "bbox": { "h": 0.15, "w": 0.86, "x": 0.07, "y": 0.45 }, "kind": "list", "text": "OCS Specialists state only one week of training before operating devices and managing organs", "attrs": null, "canon": { "kind": { "name": "List", "slug": "list", "status": "active", "canonId": "019de52c-f94b-779b-a53b-fd4904a5f4d2", "version": 1, "description": "Bullet or numbered list." }, "tool": null, "subkind": { "name": "Bullet list", "slug": "bullet", "status": "active", "canonId": "019de52c-fc98-7169-a083-5cab805076ca", "version": 1, "description": null }, "framework": null }, "subkind": "bullet", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:38.102+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "a964e694-7647-4e7c-a525-8738c0c815f2", "parentComponentId": null }, { "bbox": { "h": 0.35, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "paragraph", "text": "A former OCS Specialist indicated the importance of the role: “putting [the organ] on the machine and taking care of it – transporting and monitoring it,” including reacting to the data the machine spits out, managing fluids/solutions, and so forth – all after “they do a week-long training at the headquarters to get certified, and then you do a couple of cases, and then you’re on your own.” We asked if the minimal training caused worry: “yeah, I’m pretty stressed out with this job, that’s why I don’t work there anymore.” When we asked if technicians were engaging in the practice of medicine after one week: “yeah, it’s terrifying...because nobody ever answered that question of if something happens, then what...I definitely would have liked more training.” We then asked if issues occurred from the lack of training: “Oh yeah, I was terrified...you’re by yourself....it’s not like you can just go ask somebody to help you...then you’re on your phone calling for help.”", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:38.102+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "f3e9f2b8-9716-4783-a01b-1c51b89e918a", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "Yeah, it's terrifying...because nobody ever answered that question of if something happens, then what...I definitely would have liked more training. — Former TransMedics OCS specialist", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:18+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a984-ee4fd66604de", "parentComponentId": null }, { "bbox": { "h": 0.02, "w": 0.3, "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:38.102+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "f2247c82-9234-457f-afba-2ac1ef528d72", "parentComponentId": null } ], "metrics": [], "tools": [ { "tool": { "name": "Call to action", "slug": "call-to-action", "status": "active", "bestFor": null, "canonId": "019dd9e1-4bbb-702a-9ead-82daf188bb7c", "version": 1, "bodyDocId": null, "description": "Explicit prescription of what the audience should do next.", "familyLabel": null, "categoryName": null, "categorySlug": null }, "agent": null, "layer": "slide", "agents": null, "matchId": "31d768a7-c092-46e9-a8ac-95ae5c1e2c3e", "evidence": "The slide implies a call to action, emphasizing the need for change.", "pageRefs": null, "priority": null, "whenToUse": null, "confidence": 0.7, "extraction": { "at": "2026-07-17 03:28:52.506659+00", "model": "or:meta-llama/llama-4-scout", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 244, "whyItWorks": null, "antipattern": null, "cardinality": "common", "narrativePurpose": null } ], "frameworks": [], "arcBeats": [], "loops": [], "locked": true }, { "page": 245, "type": "tension", "title": "The slide uses a Q&A format to highlight alleged safety violations and hospital staff complaints.", "function": "expose_contradiction", "rawType": "expose_contradiction", "block": null, "metadata": { "slideType": "expose_contradiction", "slideTypeCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-124c-75aa-984a-0a3d0d8fc8df", "version": 1, "description": null }, "function": "expose_contradiction", "functionCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-171f-776f-887c-73edaff4cf9c", "version": 1, "description": null }, "density": "dense", "densityScore": 72, "componentCount": 8, "textChars": 3679, "nDataPoints": 0, "notes": "The slide uses a Q&A format to highlight alleged safety violations and hospital staff complaints.", "elementsJson": [ "paragraph", "quote_block", "footnote" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:12:40.119+00", "seconds": 4.592, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/245", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-245", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": { "h": 0.03, "w": 0.86, "x": 0.07, "y": 0.44 }, "kind": "callout", "text": "Allegedly forcing device specialist to take non-sterile equipment into OR’s", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": null, "subkind": { "name": "Primary callout", "slug": "primary", "status": "active", "canonId": "019de52c-fbd1-70eb-a9ce-8997f8674c1d", "version": 1, "description": null }, "framework": null }, "subkind": "primary", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:40.119+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "362a7e9c-7e5f-4b4b-9147-a9f254d615cc", "parentComponentId": null }, { "bbox": { "h": 0.03, "w": 0.86, "x": 0.07, "y": 0.72 }, "kind": "callout", "text": "Both NOP surgeons and device technicians allegedly “upsetting” hospitals by constantly jeopardizing the sterile field inside OR’s", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": null, "subkind": { "name": "Primary callout", "slug": "primary", "status": "active", "canonId": "019de52c-fbd1-70eb-a9ce-8997f8674c1d", "version": 1, "description": null }, "framework": null }, "subkind": "primary", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:40.119+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "601faea1-0eec-4c84-a242-faca474db1c6", "parentComponentId": null }, { "bbox": null, "kind": "callout", "text": "The technician stated that the consumable is packaged in corrugated cardboard, which TransMedics allegedly would not allow technicians to open prior to an organ being accepted – placing cost of goods above safety.", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:18+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a985-760a6d55a086", "parentComponentId": null }, { "bbox": { "h": 0.35, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "paragraph", "text": "This former OCS Specialist, unlike others, came with extensive experience inside operating rooms, and alleged that TransMedics forced technicians into reckless, unsafe practices that contaminated the sterile field, even after they raised the risks. The technician stated that the consumable is packaged in corrugated cardboard, which TransMedics allegedly would not allow technicians to open prior to an organ being accepted – placing cost of goods above safety: “I asked when I first started...’Oh, this is going to be an issue, bringing this stuff in...and they’re like, ‘It’s totally fine. Just do it.”; “going into OR’s, there are certain procedures...you can’t bring that past a red line in the OR”; “you cannot do that, and I would never do that...but they wanted you to pass the red line”; “I’ve heard a lot of complaints about their people...touching things they shouldn’t...ruining a sterile field...if you keep upsetting the staff and the hospitals, they’re going to be like...we don’t want these visitors anymore.”", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:40.119+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "aed0180a-8010-40cd-ab6d-a82ca815990e", "parentComponentId": null }, { "bbox": { "h": 0.22, "w": 0.86, "x": 0.07, "y": 0.48 }, "kind": "quote", "text": "A: “You would have questions about, like, “Why are we doing things this way?” Going in OR’s, there are certain procedures you have to follow. You’re not supposed to bring certain stuff in, like hardware, for example. That’s an issue literally anywhere you go is that you can’t bring that stuff behind a red line. And I had asked when I first started. I was like, “Oh, this is going to be an issue, bringing this stuff in?” And they’re like, “It’s totally fine. Just do it.” Q: “What was the issue? The machine is not sterile or there’s cardboard--?” A: “The package in the box that the module insert is in is corrugated cardboard, and you can’t bring that past a red line at the OR. You’re supposed to take this out because you can’t bring the box past that line technically. But they were like, “Oh, it’s totally fine. You can do it.” I would never take it into an operating room because you cannot do that, and I would never do that. But they wanted you to pass the red line.” - Former TransMedics OCS specialist", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:40.119+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "8e928f63-e790-4e44-8f64-9d8d5a32f2bb", "parentComponentId": null }, { "bbox": { "h": 0.15, "w": 0.86, "x": 0.07, "y": 0.76 }, "kind": "quote", "text": "A: “In an OR, people are high-strung about what you cannot touch. Certain things you do not do. I’ve heard a lot of complaints about their people coming in and doing that, touching things they shouldn’t, being too close to the sterile field, ruining a sterile field - if you keep upsetting the staff and the hospitals, they’re going to be like, we don’t want these visitors anymore.” Q: “And who’s doing this? The surgeon that TransMedics is using for procurement? Somebody who’s tagging along? Who’s doing that?” A: “Sometimes it’s the surgeon, sometimes it’s the OCS specialist.” - Former TransMedics OCS specialist", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:40.119+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "b558d012-b1a5-4fed-bb5c-108035bb406c", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "“I asked when I first started...’Oh, this is going to be an issue, bringing this stuff in...and they’re like, ‘It’s totally fine. Just do it.”; “you can’t bring that past a red line in the OR”; “you cannot do that, and I would never do that...but they wanted you to pass the red line”; “I’ve heard a lot of complaints about their people...touching things they shouldn’t...ruining a sterile field...if you keep upsetting the staff and the hospitals, they’re going to be like...we don’t want these visitors anymore.” — Former TransMedics OCS specialist", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:18+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a985-791008bdbe28", "parentComponentId": null }, { "bbox": { "h": 0.02, "w": 0.25, "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:40.119+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "7eb33f3f-0637-43c7-823e-ac1da1988ea5", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [], "arcBeats": [], "loops": [], "locked": true }, { "page": 246, "type": "tension", "title": "The slide uses a narrative format to expose operational failures and potential ethical/regulatory concerns regarding TransMedics' high-volume users.", "function": "name_villain", "rawType": "villain_critique", "block": null, "metadata": { "slideType": "villain_critique", "slideTypeCanon": { "name": "Villain critique", "slug": "villain_critique", "status": "active", "canonId": "019de52d-10bc-7136-bf20-09de59d17447", "version": 1, "description": null }, "function": "name_villain", "functionCanon": { "name": "Name villain", "slug": "name_villain", "status": "active", "canonId": "019de52d-1746-70d6-bc58-5eeaf5865526", "version": 1, "description": null }, "density": "dense", "densityScore": 69, "componentCount": 8, "textChars": 2548, "nDataPoints": 0, "notes": "The slide uses a narrative format to expose operational failures and potential ethical/regulatory concerns regarding TransMedics' high-volume users.", "elementsJson": [ "paragraph", "quote_block", "footnote" ], "confidence": 0.95, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:12:39.323+00", "seconds": 3.652, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/246", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-246", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "The technician called out practices at UC San Diego in a particular, one of TransMedics highest-volume users and who we believe to be using the device off-label for scheduling and for dubious organs other centers won’t touch, to boost their volumes.", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:18+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a985-446bdb28a9e1", "parentComponentId": null }, { "bbox": { "h": 0.05, "w": 0.86, "x": 0.07, "y": 0.55 }, "kind": "list", "text": "OCS specialists “wander” around with no procedure/protocols at receiving centers; surgeons disinterested in monitoring organ", "attrs": null, "canon": { "kind": { "name": "List", "slug": "list", "status": "active", "canonId": "019de52c-f94b-779b-a53b-fd4904a5f4d2", "version": 1, "description": "Bullet or numbered list." }, "tool": null, "subkind": { "name": "Bullet list", "slug": "bullet", "status": "active", "canonId": "019de52c-fc98-7169-a083-5cab805076ca", "version": 1, "description": null }, "framework": null }, "subkind": "bullet", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:39.323+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "331bede5-5f53-4805-8231-82efca0928aa", "parentComponentId": null }, { "bbox": { "h": 0.45, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "paragraph", "text": "The OCS Specialist detailed similar disarray upon arriving at recipient centers, left to wander the halls for 24 hours or more with an organ, unable to sleep, with receiving transplant surgeons simply disinterred in checking on the organ until surgery.", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:39.323+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "4688cc19-06f9-4224-abbb-e6d341d66631", "parentComponentId": null }, { "bbox": { "h": 0.15, "w": 0.86, "x": 0.07, "y": 0.61 }, "kind": "paragraph", "text": "Q: “When you would arrive at a transplant center, would you meet the surgeon? Who would show up? What would the procedure be?” A: “[Laughs] I would show up and I think it happened once where someone actually met me and showed me where to go and checked me in and everything. But other than that, it was like figure it out for yourself. But I would get dropped off at the recipient hospital, and I would wander through until I found the OR. Sometimes somebody would be kind enough to show me the way, and then I would find the desk. Sometimes, they didn’t want to see it until they wanted me in the OR.”", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:39.323+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "8d71b93e-92e5-48d1-88e4-a412de214f20", "parentComponentId": null }, { "bbox": { "h": 0.12, "w": 0.86, "x": 0.07, "y": 0.76 }, "kind": "paragraph", "text": "Q: “How long did they keep you waiting sometimes?” A: “A long time, like hours. Like overnight...they would want you to wait overnight, and then they would do the first case in the morning, so you would just wait all night long, and then they would do a 6 am or 7 am start. And then the same with San Diego. I think I always waited there. It was always like whatever time you showed up, and then it would be like the next morning. Another time I had to wait for another liver to go, and then I went after it. I got there at night and I was waiting until noon or 2 pm the next day before I went in.", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:39.323+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "afa3c24f-5a5c-4f00-8999-fc83d7ef9c6f", "parentComponentId": null }, { "bbox": { "h": 0.08, "w": 0.86, "x": 0.07, "y": 0.88 }, "kind": "paragraph", "text": "Q: “And nobody’s coming to even look and check out the organ and talk to you. You’re just on your own?” A: “There were certain places that were very good about coming to look at it. But other docs were less careful about coming and seeing it—they would show up right before they would take the patient back...they just don’t put eyes on it, and we’re not sending pictures to the receiving surgeons after it’s on the machine.” - Former TransMedics OCS specialist", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:39.323+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "c76e4fb8-e5ef-4a75-8d21-0a869ec5e455", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "“someone actually met and showed me where to go...it was like, figure it out yourself...I would wander through until I found the OR...a long time, like hours...overnight.” — Former TransMedics OCS specialist", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:18+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a985-4a8abab47c30", "parentComponentId": null }, { "bbox": { "h": 0.02, "w": 0.3, "x": 0.07, "y": 0.96 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:39.323+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "1931e785-ccb6-45d3-bfce-063e5c9259d8", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [], "arcBeats": [], "loops": [], "locked": true }, { "page": 247, "type": "tension", "title": "The slide uses direct quotes to highlight operational risks and potential regulatory/ethical violations regarding the use of OCS specialists.", "function": "expose_contradiction", "rawType": "quote_slide", "block": null, "metadata": { "slideType": "quote_slide", "slideTypeCanon": { "name": "Quote slide", "slug": "quote_slide", "status": "active", "canonId": "019de52d-098e-7555-a9fd-4f0af7e80bc2", "version": 1, "description": null }, "function": "expose_contradiction", "functionCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-171f-776f-887c-73edaff4cf9c", "version": 1, "description": null }, "density": "balanced", "densityScore": 43, "componentCount": 6, "textChars": 1285, "nDataPoints": 0, "notes": "The slide uses direct quotes to highlight operational risks and potential regulatory/ethical violations regarding the use of OCS specialists.", "elementsJson": [ "paragraph", "quote_block" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:12:38.976+00", "seconds": 2.706, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/247", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-247", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "The specialist detailed tasks that strike us as the practice of medicine – after a week of training: \"all these drugs you have to put on...you have to put on the blood...and sample it.\"", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:19+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a986-47486ac76c3f", "parentComponentId": null }, { "bbox": { "h": 0.35, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "paragraph", "text": "A second OCS Specialist provided similar color, and elaborated on their improper use as surgical assistants despite no such training or credentials, as well as their engaging in the practice of medicine...", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:38.976+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "e9016aa0-4780-497d-919c-6823cad6076d", "parentComponentId": null }, { "bbox": { "h": 0.18, "w": 0.86, "x": 0.07, "y": 0.75 }, "kind": "quote", "text": "You are by yourself. It’s like an OCS specialist and then a surgeon, and it is stressful because they’re wanting you to call out times...you also have to put in the cardioplegia...you have to put on the blood and get that pumping and you have to sample it.", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:38.976+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "3ecf1fd9-b486-4182-ad83-a91b27e29eb4", "parentComponentId": null }, { "bbox": { "h": 0.12, "w": 0.86, "x": 0.07, "y": 0.58 }, "kind": "quote", "text": "A lot of the OCS specialists struggled...a lot of these people were coming in and they’ve never navigated an OR...it is stressful because you only get that one week of training...you do it once and then you’re kicked out of the nest.", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:38.976+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "8e0c6493-e7be-41ba-89ae-71de02f052fb", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "\"A lot of the OCS specialists struggled...a lot of these people were coming in and they've never navigated an OR...so much stuff they don't know about an OR...it is stressful because you only get that one week of training...it kind of blows your mind...you do it once and then you're kicked out of the nest.\" — Former OCS Specialist who left recently", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:19+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a986-4aeed649c08c", "parentComponentId": null }, { "bbox": { "h": 0.02, "w": 0.3, "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:38.976+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "4943fc96-9886-4cf0-9e87-43971b3f01b2", "parentComponentId": null } ], "metrics": [], "tools": [ { "tool": { "name": "Anadiplosis", "slug": "anadiplosis", "status": "active", "bestFor": null, "canonId": "019dd956-a0a5-75f9-a98c-7b7d8ee377a1", "version": 1, "bodyDocId": null, "description": "Ending one clause with a word that begins the next", "familyLabel": null, "categoryName": "Loop", "categorySlug": "loop" }, "agent": "Storyteller", "layer": "slide", "agents": [ "Storyteller" ], "matchId": "2e843d80-f267-44c6-bb0b-ebca8402693e", "evidence": "A second OCS Specialist provided similar color, and elaborated on their improper use as surgical assistants despite no such training or credentials, as well as their engaging in the practice of medicine", "pageRefs": null, "priority": null, "whenToUse": null, "confidence": 0.7, "extraction": { "at": "2026-07-16 23:10:40.440202+00", "model": "or:meta-llama/llama-4-scout", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 247, "whyItWorks": null, "antipattern": null, "cardinality": null, "narrativePurpose": null }, { "tool": { "name": "Call-and-Response", "slug": "call-and-response", "status": "active", "bestFor": null, "canonId": "019dd956-a254-7484-a9b7-721eb21444a5", "version": 1, "bodyDocId": null, "description": "Engaging audience by creating pattern they complete mentally", "familyLabel": null, "categoryName": "Loop", "categorySlug": "loop" }, "agent": "Storyteller", "layer": "slide", "agents": [ "Storyteller" ], "matchId": "773e09ed-114f-4860-ac1e-a40cb0dab8e9", "evidence": "quote/testimonial: You are by yourself. It’s like an OCS specialist and then a surgeon, and it is stressful because they’re wanting you to call out times...you also have to put in the cardioplegia...you have to put on th", "pageRefs": null, "priority": null, "whenToUse": null, "confidence": 0.7, "extraction": { "at": "2026-07-16 23:10:40.474109+00", "model": "or:meta-llama/llama-4-scout", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 247, "whyItWorks": null, "antipattern": null, "cardinality": null, "narrativePurpose": null } ], "frameworks": [], "arcBeats": [], "loops": [], "locked": true }, { "page": 248, "type": "tension", "title": "The slide uses a Q&A transcript format to substantiate claims of poor management and safety negligence.", "function": "expose_contradiction", "rawType": "expose_contradiction", "block": null, "metadata": { "slideType": "expose_contradiction", "slideTypeCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-124c-75aa-984a-0a3d0d8fc8df", "version": 1, "description": null }, "function": "expose_contradiction", "functionCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-171f-776f-887c-73edaff4cf9c", "version": 1, "description": null }, "density": "balanced", "densityScore": 27, "componentCount": 5, "textChars": 821, "nDataPoints": 0, "notes": "The slide uses a Q&A transcript format to substantiate claims of poor management and safety negligence.", "elementsJson": [ "paragraph", "quote_block", "footnote" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:12:38.784+00", "seconds": 2.404, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/248", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-248", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "The technician stated the company didn’t even have a protocol for needlesticks, as an indication of the overall level of recklessness.", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:18+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a985-2f4c45960fcf", "parentComponentId": null }, { "bbox": { "h": 0.35, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "paragraph", "text": "The second ex-OCS Specialist noted the predictable, rampant turnover and the company's inability to hold on to technicians – with the CEO allegedly lashing out when asked during a town hall...", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:38.784+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "a554d716-44b3-4b16-a51c-808ab62f0ac6", "parentComponentId": null }, { "bbox": { "h": 0.45, "w": 0.86, "x": 0.07, "y": 0.44 }, "kind": "quote", "text": "Rapid and \"huge turnover\" in OCS specialists; CEO allegedly told them to quit during town hall question; \"nasty\"", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:38.784+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "2f44d98f-d6a6-4cec-8b3d-9e060100f1b7", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "“Well, if you don’t— he got really kind of nasty. He’s like, ‘Well, if you don’t like it, then leave,’ when somebody was asking questions about improving things, and that was just their answer to it, which I thought was weird that you’re not worried about turnover in a job like this.” — Former OCS Specialist who left recently", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:18+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a985-313b94cec39a", "parentComponentId": null }, { "bbox": { "h": 0.02, "w": 0.25, "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:38.784+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "916d471d-99a0-43ab-8a80-93c6755b0891", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [ { "matchId": "bfb33bce-8408-4e29-a2ae-126a3cc783d2", "evidence": "The slide frames the CEO as the antagonist through the reported hostile quote.", "framework": null, "confidence": 0.8, "extraction": { "at": "2026-05-02 20:12:38.784+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 248, "frameworkName": "antagonist-introduction" } ], "arcBeats": [], "loops": [], "locked": true }, { "page": 249, "type": "setup", "function": "transition", "rawType": "section_divider", "block": null, "metadata": { "slideType": "section_divider", "slideTypeCanon": { "name": "Section divider", "slug": "section_divider", "status": "active", "canonId": "019de52d-066a-7402-9554-6ae504999041", "version": 1, "description": null }, "function": "transition", "functionCanon": { "name": "Transition", "slug": "transition", "status": "active", "canonId": "019de52d-1365-7149-92aa-66df859e75fd", "version": 1, "description": null }, "density": "sparse", "densityScore": 10, "componentCount": 2, "textChars": 496, "nDataPoints": 0, "notes": null, "elementsJson": [ "paragraph" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:12:38.408+00", "seconds": 1.968, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/249", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-249", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "Part 10. Customer rage: TransMedics business practices have antagonized the small world of transplant, past the point of no return – a short-tempered CEO; allegedly threatening centers who state that organs have been held hostage from ill patients.", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:18+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a984-c3f6e113eba0", "parentComponentId": null }, { "bbox": { "x": 0.07, "y": 0.07 }, "kind": "title", "text": "Part 10. Customer rage: TransMedics business practices have antagonized the small world of transplant, past the point of no return – a short-tempered CEO; allegedly threatening centers who state that organs have been held hostage from ill patients.", "attrs": null, "canon": { "kind": { "name": "Title", "slug": "title", "status": "active", "canonId": "019de52c-f7dd-76d9-b848-b1f12bd85cf4", "version": 1, "description": "Slide title or headline." }, "tool": null, "subkind": { "name": "Headline", "slug": "headline", "status": "active", "canonId": "019de52c-fae1-7463-9a7c-d60668eced0d", "version": 1, "description": null }, "framework": null }, "subkind": "headline", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:38.408+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "3a0812b6-f827-4b37-81c8-9dc0a4138a33", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [], "arcBeats": [], "loops": [], "locked": true }, { "page": 250, "type": "tension", "title": "The slide uses strong, emotive language to frame the company's leadership as the primary antagonist.", "function": "name_villain", "rawType": "villain_critique", "block": null, "metadata": { "slideType": "villain_critique", "slideTypeCanon": { "name": "Villain critique", "slug": "villain_critique", "status": "active", "canonId": "019de52d-10bc-7136-bf20-09de59d17447", "version": 1, "description": null }, "function": "name_villain", "functionCanon": { "name": "Name villain", "slug": "name_villain", "status": "active", "canonId": "019de52d-1746-70d6-bc58-5eeaf5865526", "version": 1, "description": null }, "density": "dense", "densityScore": 53, "componentCount": 6, "textChars": 2529, "nDataPoints": 0, "notes": "The slide uses strong, emotive language to frame the company's leadership as the primary antagonist.", "elementsJson": [ "paragraph", "callout_box", "footnote" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:12:40.213+00", "seconds": 3.458, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/250", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-250", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": { "h": 0.08, "w": 0.86, "x": 0.07, "y": 0.78 }, "kind": "callout", "text": "“Dishonest” and “claims are exaggerated”\n“[W]e’ve been involved in some of their trials...their company, from a corporate culture point of view, is dishonest, to be blunt, and I think their claims are exaggerated.” – Prominent surgeon, Director of a leading academic transplant center", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": null, "subkind": { "name": "Primary callout", "slug": "primary", "status": "active", "canonId": "019de52c-fbd1-70eb-a9ce-8997f8674c1d", "version": 1, "description": null }, "framework": null }, "subkind": "primary", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:40.213+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "021ef2d3-36e8-4292-a030-5d6685ad5239", "parentComponentId": null }, { "bbox": { "h": 0.18, "w": 0.86, "x": 0.07, "y": 0.58 }, "kind": "callout", "text": "CEO is “so disingenuous” – disliked by hospitals\n“I don’t like Waleed or a lot of their upper management...he’s doing the fake it ‘til you make it thing. He doesn’t acknowledge facts. He doesn’t acknowledge the fact that reimbursement is an issue. He doesn’t acknowledge that there are other companies that are out there with technology. He always badmouths every other company when, in fact, other companies have got some really great ideas to the point, by the way—and this goes to show you what a fuck-face he is...he’s so disingenuous...” – Prominent surgeon, Director of a leading academic transplant center", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": null, "subkind": { "name": "Primary callout", "slug": "primary", "status": "active", "canonId": "019de52c-fbd1-70eb-a9ce-8997f8674c1d", "version": 1, "description": null }, "framework": null }, "subkind": "primary", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:40.213+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "1bd40d2e-9a55-41ea-8388-f85490bed30d", "parentComponentId": null }, { "bbox": null, "kind": "callout", "text": "I don't like Waleed or a lot of their upper management...he's doing the fake it 'til you make it thing. He doesn't acknowledge facts.", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:19+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a986-1666334fb29e", "parentComponentId": null }, { "bbox": { "h": 0.45, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "paragraph", "text": "TransMedics practices have broadly antagonized the entire transplant field, past the point of no return and consistent with a company in the midst of a customer exodus and death spiral. The level of rage, venom, and expletives – towards its CEO and management team, in particular - is unlike anything we have ever heard. Across dozens of interviews with surgeons, transplant center administrators, and ex-executives/employees, the sentiment was universal. Notably, its highest-volume users exhibited similar animus and signaled their intent to eliminate or sharply reduce use of the TransMedics device as soon as possible. We begin with a prominent KOL and Director of a leading academic transplant center – whose colorful language was representative. The KOL is well-published with a national reputation, participated in TransMedics trials, and knows the CEO well: “their company, from a corporate culture point of view, is dishonest...their claims are exaggerated”; “I don’t like Waleed or a lot of their upper management...he’s doing the fake it til you make it thing...what a fuck-face he is...he’s so disingenuous.”", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:40.213+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "481b80c4-00e9-436f-87b7-466bf688deab", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "\"their company, from a corporate culture point of view, is dishonest...their claims are exaggerated\"; \"I don't like Waleed or a lot of their upper management...he's doing the fake it til you make it thing...what a fuck-face he is...he's so disingenuous.\" — Prominent surgeon, Director of a leading academic transplant center", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:19+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a986-194a3a01f508", "parentComponentId": null }, { "bbox": { "h": 0.02, "w": 0.25, "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:40.213+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "8d0c17d2-8a0a-479c-aac7-74c239345be0", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [ { "matchId": "3417c53c-3962-41fc-98a3-4bd2f14b22a9", "evidence": "The slide explicitly frames the CEO and management as the 'villain' or antagonist causing a 'death spiral'.", "framework": null, "confidence": 0.9, "extraction": { "at": "2026-05-02 20:12:40.213+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 250, "frameworkName": "antagonist-introduction" } ], "arcBeats": [], "loops": [], "locked": true }, { "page": 251, "type": "tension", "title": "The slide uses highlighted text to emphasize key grievances (dishonesty, forced bundling, anger).", "function": "name_villain", "rawType": "villain_critique", "block": null, "metadata": { "slideType": "villain_critique", "slideTypeCanon": { "name": "Villain critique", "slug": "villain_critique", "status": "active", "canonId": "019de52d-10bc-7136-bf20-09de59d17447", "version": 1, "description": null }, "function": "name_villain", "functionCanon": { "name": "Name villain", "slug": "name_villain", "status": "active", "canonId": "019de52d-1746-70d6-bc58-5eeaf5865526", "version": 1, "description": null }, "density": "overcrowded", "densityScore": 84, "componentCount": 10, "textChars": 3455, "nDataPoints": 0, "notes": "The slide uses highlighted text to emphasize key grievances (dishonesty, forced bundling, anger).", "elementsJson": [ "paragraph", "callout_box", "footnote" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:12:41.232+00", "seconds": 4.336, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/251", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-251", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "The alienation...some of us really hate Waleed because we just think he’s dishonest with the way he talks...and he gets angry when people say, no, we’re not getting reimbursed, and it pisses him off and his people off.", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:19+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a985-ea61bba8dcb5", "parentComponentId": null }, { "bbox": { "h": 0.04, "w": 0.86, "x": 0.07, "y": 0.41 }, "kind": "paragraph", "text": "“The alienation” - CEO and his team “get angry” when hospitals indicate the product is uneconomic to use", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:41.232+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "09481d05-11c0-4d6d-a7bd-fb498e929003", "parentComponentId": null }, { "bbox": { "h": 0.03, "w": 0.86, "x": 0.07, "y": 0.58 }, "kind": "paragraph", "text": "Alienated the field by forcing NOP use; “ridiculous” for organs nearby", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:41.232+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "1dbdf2f3-34aa-4a83-824b-243cc1a10c93", "parentComponentId": null }, { "bbox": { "h": 0.03, "w": 0.86, "x": 0.07, "y": 0.8 }, "kind": "paragraph", "text": "“Push down your throat” – pushing people to use any competitor, like LifePort", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:41.232+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "fb0a65e1-7a0c-4399-af7a-c6308dcf34e1", "parentComponentId": null }, { "bbox": { "h": 0.12, "w": 0.86, "x": 0.07, "y": 0.83 }, "kind": "quote", "text": "“Cleveland Clinic and the guys at the University of Chicago, two centers I think are really good, both are on board with the LifePort study and, in addition, because of the fact that TransMedics acted as this hard sell, push down your throat approach to the surgical community saying this is our way or the highway, there are a lot of people they pissed off. So, I think even if LifePort trials showed the exact same results as TransMedics, I think there’s actually be people who would say I’m using LifePort just because it’s not TransMedics.” – Prominent surgeon, Director of a leading academic transplant center", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:41.232+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "0023d06b-f0a1-4666-882f-716a2b8e2dbd", "parentComponentId": null }, { "bbox": { "h": 0.18, "w": 0.86, "x": 0.07, "y": 0.61 }, "kind": "quote", "text": "“TransMedics has been charging a lot of money for not only the device but also their NOP program, their aviation company - all the stuff that they’ve rolled in and they tried to force it down everybody’s throat that to use their liver device, you had to do everything. It was a price-fixed dinner; you couldn’t do a la carte...the push from all of us in the surgical community saying this is ridiculous that you are forcing us to use your hired surgeon and aviation company when we would prefer to use our own surgeon...if you’re going to be getting an organ that’s from a DCD donor that’s only 150 miles away and you can drive there with your liver team, why would you need to use their aviation company and their surgeon when you could provide those services yourself and improve your contribution margin because these technologies do really whittle away at your bottom line for the hospital.” – Prominent surgeon, Director of a leading academic transplant center", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:41.232+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "aa329128-1d39-49e9-8016-eee11c1f834a", "parentComponentId": null }, { "bbox": { "h": 0.12, "w": 0.86, "x": 0.07, "y": 0.45 }, "kind": "quote", "text": "“The alienation...some of us really hate Waleed because we just think he’s dishonest with the way he talks...and he gets angry when people say, no, we’re not getting reimbursed, and it pisses him off and his people off. They always get angry at the meetings when people get up and say, yeah, but we actually did a financial analysis, and they’ve also presented at a symposium at the ATC.” – Prominent surgeon, Director of a leading academic transplant center", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:41.232+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "e3974a58-e24f-4a22-9795-09825f8cc9ce", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "“The alienation...some of us really hate Waleed because we just think he’s dishonest with the way he talks...and he gets angry when people say, no, we’re not getting reimbursed, and it pisses him off and his people off. They always get angry at the meetings when people get up and say, yeah, but we actually did a financial analysis, and Duke University did a beautiful analysis - they presented it at the meetings where they showed how much of a hit they took with TransMedics liver use at their center. They presented this at one TransMedics user meeting, and then they've also presented it at a symposium at the ATC.” — Prominent surgeon, Director of a leading academic transplant center", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:19+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a985-ec739241790f", "parentComponentId": null }, { "bbox": { "h": 0.02, "w": 0.3, "x": 0.07, "y": 0.96 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:41.232+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "53d9e019-21d1-4a25-8439-037e8b93ca84", "parentComponentId": null }, { "bbox": { "h": 0.15, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "title", "text": "The surgeon commented on the alienation and backlash in the transplant community, and noted the CEO’s allegedly reactive personality – a recurring theme of interviews which described “screaming” episodes", "attrs": null, "canon": { "kind": { "name": "Title", "slug": "title", "status": "active", "canonId": "019de52c-f7dd-76d9-b848-b1f12bd85cf4", "version": 1, "description": "Slide title or headline." }, "tool": null, "subkind": { "name": "Headline", "slug": "headline", "status": "active", "canonId": "019de52c-fae1-7463-9a7c-d60668eced0d", "version": 1, "description": null }, "framework": null }, "subkind": "headline", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:12:41.232+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "579f01d1-3dc3-4c09-bbbe-05af589703b7", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [], "arcBeats": [], "loops": [], "locked": true }, { "page": 252, "type": "tension", "title": "The slide uses direct quotes from KOLs to build a negative narrative around the company's business ethics.", "function": "expose_contradiction", "rawType": "expose_contradiction", "block": null, "metadata": { "slideType": "expose_contradiction", "slideTypeCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-124c-75aa-984a-0a3d0d8fc8df", "version": 1, "description": null }, "function": "expose_contradiction", "functionCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-171f-776f-887c-73edaff4cf9c", "version": 1, "description": null }, "density": "dense", "densityScore": 54, "componentCount": 7, "textChars": 1492, "nDataPoints": 0, "notes": "The slide uses direct quotes from KOLs to build a negative narrative around the company's business ethics.", "elementsJson": [ "paragraph", "quote_block" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 21:25:50.298+00", "seconds": 2.889, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/252", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-252", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "a lot of people are very pissed off with the company...a lot of people are very pissed off because they are acting too greedy and predatory. I really support that letter from that Congressman. Again, a lot of people in different transplant centers are very pissed off.... I can tell you, I hate the CEO.", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:19+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a986-0337808b8ebc", "parentComponentId": null }, { "bbox": { "h": 0.15, "w": 0.86, "x": 0.07, "y": 0.28 }, "kind": "paragraph", "text": "The Vanderbilt surgeon played a role in TransMedics pivotal PROTECT trial and seethed at the bait-and-switch after FDA approval when the pricing spiked.", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:25:50.298+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "522c938b-ef70-49a8-abfe-4f327722602d", "parentComponentId": null }, { "bbox": { "h": 0.12, "w": 0.86, "x": 0.07, "y": 0.82 }, "kind": "quote", "text": "All about the money; eager for any alternative... dealing with Waleed on contracts... it's all about the money... I'm just hoping that with these other devices coming into market...", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:25:50.298+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "39163909-bb79-4a34-a500-9fc90b594c79", "parentComponentId": null }, { "bbox": { "h": 0.25, "w": 0.86, "x": 0.07, "y": 0.55 }, "kind": "quote", "text": "People are very pissed off; bait and switch... I don't like the Transmedics people that much... They basically did a bait-and-switch with the investigators.", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:25:50.298+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "b5a15ffc-f09d-43a9-aad0-d5f86ff775d6", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "\"dealing with Waleed...it’s all about the money...I’m just hoping that with these other devices coming into the market....\" — One of the top liver transplant surgeons in the world, based at a leading Midwest academic center. \"I don’t like the TransMedics people...to be honest with you, a lot of people are very pissed off...they are acting too greedy and predatory...I really support that letter from the Congressman...a lot of the people in different transplant centers are very pissed off...I can tell you, I hate the CEO.\" — Transplant surgeon at Vanderbilt.", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:19+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a986-04169d8bcfc4", "parentComponentId": null }, { "bbox": { "h": 0.02, "w": 0.25, "x": 0.07, "y": 0.96 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:25:50.298+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "05b06ecf-4bae-4d41-b72c-e8dbd829c721", "parentComponentId": null }, { "bbox": { "h": 0.15, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "title", "text": "We quote two other surgeon KOL's, both prominent and widely respected in the field", "attrs": null, "canon": { "kind": { "name": "Title", "slug": "title", "status": "active", "canonId": "019de52c-f7dd-76d9-b848-b1f12bd85cf4", "version": 1, "description": "Slide title or headline." }, "tool": null, "subkind": { "name": "Headline", "slug": "headline", "status": "active", "canonId": "019de52c-fae1-7463-9a7c-d60668eced0d", "version": 1, "description": null }, "framework": null }, "subkind": "headline", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:25:50.298+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "c78a936c-c963-4852-b943-80bf1c5868c5", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [ { "matchId": "685c5608-1011-4f52-88be-a1dcc64f2dcf", "evidence": "Uses expert testimony to allege predatory pricing and bait-and-switch tactics.", "framework": null, "confidence": 0.9, "extraction": { "at": "2026-05-02 21:25:50.298+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 252, "frameworkName": "fraud-exposure" } ], "arcBeats": [], "loops": [], "locked": true }, { "page": 253, "type": "tension", "title": "The slide uses highlighted text to emphasize key quotes from former executives regarding the CEO's professional conduct.", "function": "name_villain", "rawType": "villain_critique", "block": null, "metadata": { "slideType": "villain_critique", "slideTypeCanon": { "name": "Villain critique", "slug": "villain_critique", "status": "active", "canonId": "019de52d-10bc-7136-bf20-09de59d17447", "version": 1, "description": null }, "function": "name_villain", "functionCanon": { "name": "Name villain", "slug": "name_villain", "status": "active", "canonId": "019de52d-1746-70d6-bc58-5eeaf5865526", "version": 1, "description": null }, "density": "dense", "densityScore": 60, "componentCount": 7, "textChars": 2238, "nDataPoints": 0, "notes": "The slide uses highlighted text to emphasize key quotes from former executives regarding the CEO's professional conduct.", "elementsJson": [ "paragraph", "quote_block" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 21:25:51.576+00", "seconds": 3.921, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/253", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-253", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": { "h": 0.15, "w": 0.85, "x": 0.07, "y": 0.45 }, "kind": "callout", "text": "Allegedly “not well-liked” and viewed as “insane” by the transplant community. “He is not well-liked. His style with the community of physicians. My contacts are mainly with the heart transplant centers... When I joined, my phone just kept ringing, saying are you crazy? That man is insane... he was just like, I will do anything that I can to not use this device.”", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": null, "subkind": { "name": "Primary callout", "slug": "primary", "status": "active", "canonId": "019de52c-fbd1-70eb-a9ce-8997f8674c1d", "version": 1, "description": null }, "framework": null }, "subkind": "primary", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:25:51.576+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "5c7d9986-a16d-41ab-aaed-4d638651014e", "parentComponentId": null }, { "bbox": { "h": 0.15, "w": 0.85, "x": 0.07, "y": 0.62 }, "kind": "callout", "text": "An alleged incendiary email from CEO – “public shaming” at a key meeting alienated users of the device. “The public shaming was the topic of conversation. That’s all anybody could talk about. It was just the buzz of the meeting. A cloud was cast, as you can imagine, over the enthusiasm of using OCS for DCD.”", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": null, "subkind": { "name": "Primary callout", "slug": "primary", "status": "active", "canonId": "019de52c-fbd1-70eb-a9ce-8997f8674c1d", "version": 1, "description": null }, "framework": null }, "subkind": "primary", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:25:51.576+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "e576c905-033e-4bbf-ad4f-bed95bc4c7c5", "parentComponentId": null }, { "bbox": null, "kind": "callout", "text": "He is not well-liked. His style with the community of physicians. My contacts are mainly with the heart transplant centers, including the administrators all the way up to the C Suite in lots of cases. When I joined, my phone just kept ringing, saying are you crazy? That man is insane.", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:18+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a985-be024869c9ca", "parentComponentId": null }, { "bbox": { "h": 0.25, "w": 0.85, "x": 0.07, "y": 0.19 }, "kind": "paragraph", "text": "An ex-executive, with a long tenure and extensive contacts at transplant centers around the country, state that “when I joined, my phone just kept ringing, saying are you crazy? That man is insane.” The executive stated that “he is not well liked” due to his “style with the community of physicians,” mentioning an illustrative cardiovascular surgeon – “he was just like, I will do anything that I can to not use this device.” Other anecdotes included an alleged email that insulted physicians at a key annual conference: “the public shaming was the topic of conversation...it was just the buzz of the meeting...a cloud as was cast...over the enthusiasm of using OCS.”", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:25:51.576+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "7b0d56fc-9c92-463a-8922-74eeec10b4ac", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "“when I joined, my phone just kept ringing, saying are you crazy? That man is insane.” — Former executive in a key reimbursement role; “he was just like, I will do anything that I can to not use this device.” — Former executive in a key reimbursement role; “the public shaming was the topic of conversation...it was just the buzz of the meeting...a cloud as was cast...over the enthusiasm of using OCS.” — Former executive in a key reimbursement role", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:18+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a985-c27d19a2a0e9", "parentComponentId": null }, { "bbox": { "h": 0.03, "w": 0.3, "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:25:51.576+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "51fc0b3a-f4f9-4a39-a779-666d5a697c9d", "parentComponentId": null }, { "bbox": { "h": 0.12, "w": 0.85, "x": 0.07, "y": 0.07 }, "kind": "title", "text": "Former employees provided various anecdotes to illustrate the CEO’s questionable reputation and behavior.", "attrs": null, "canon": { "kind": { "name": "Title", "slug": "title", "status": "active", "canonId": "019de52c-f7dd-76d9-b848-b1f12bd85cf4", "version": 1, "description": "Slide title or headline." }, "tool": null, "subkind": { "name": "Headline", "slug": "headline", "status": "active", "canonId": "019de52c-fae1-7463-9a7c-d60668eced0d", "version": 1, "description": null }, "framework": null }, "subkind": "headline", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:25:51.576+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "ca633a6c-69ac-462a-a4d6-bb833a7185a6", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [], "arcBeats": [], "loops": [], "locked": true }, { "page": 254, "type": "tension", "title": "The slide uses direct quotes from former employees and industry contacts to build a negative narrative around the CEO's personality and professional standing.", "function": "name_villain", "rawType": "villain_critique", "block": null, "metadata": { "slideType": "villain_critique", "slideTypeCanon": { "name": "Villain critique", "slug": "villain_critique", "status": "active", "canonId": "019de52d-10bc-7136-bf20-09de59d17447", "version": 1, "description": null }, "function": "name_villain", "functionCanon": { "name": "Name villain", "slug": "name_villain", "status": "active", "canonId": "019de52d-1746-70d6-bc58-5eeaf5865526", "version": 1, "description": null }, "density": "balanced", "densityScore": 43, "componentCount": 6, "textChars": 1272, "nDataPoints": 0, "notes": "The slide uses direct quotes from former employees and industry contacts to build a negative narrative around the CEO's personality and professional standing.", "elementsJson": [ "paragraph", "quote_block", "footnote" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 21:25:50.857+00", "seconds": 2.997, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/254", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-254", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "Waleed literally stood up and said, 'Who are you and why do you think you can sit at my table?' It was very upsetting and insulting", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:19+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a986-73b8b5c9026d", "parentComponentId": null }, { "bbox": { "h": 0.25, "w": 0.86, "x": 0.07, "y": 0.66 }, "kind": "paragraph", "text": "CEO is \"very short-tempered\" and \"screamed at people a lot\"; lacks credibility in the field. A: \"Waleed is very short-tempered. He screamed at people a lot and he could be pretty unprofessional...\"", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:25:50.857+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "38057381-8126-455c-92d5-058e149451a9", "parentComponentId": null }, { "bbox": { "h": 0.25, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "paragraph", "text": "The executive commented on the CEO's allegedly short temper as a source of alienation among transplant surgeons, sharing another anecdote where a surgeon accidentally sat in an assigned seat at Hassanein's table during a conference.", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:25:50.857+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "8051ca98-5710-4e1a-a239-277e5008c86f", "parentComponentId": null }, { "bbox": { "h": 0.15, "w": 0.86, "x": 0.07, "y": 0.48 }, "kind": "paragraph", "text": "Allegedly berated and insulted KOL who accidentally at his dinner table at a conference. The International Society of Heart-Lung Transplant. It's the biannual meeting...", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:25:50.857+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "963ac088-40b2-4f07-9280-a9c875bb7be7", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "“Waleed literally stood up and said, ‘Who are you and why do you think you can sit at my table?’ It was very upsetting and insulting” — Former executive in a key reimbursement role; “Waleed is very short-tempered. He screamed at people a lot and he could be pretty unprofessional...there was a running joke that whenever a customer is asking too many questions...he’d be like, ‘Oh my God, such and such idiots.’” — Former longtime employee in senior medical safety/clinical safety roles.", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:19+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a986-743ee3f804b6", "parentComponentId": null }, { "bbox": { "h": 0.03, "w": 0.3, "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:25:50.857+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "ca951726-cf8c-4aaa-8814-ee5b6e859f47", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [], "arcBeats": [], "loops": [], "locked": true }, { "page": 255, "type": "tension", "title": "The slide uses a combination of summary text and a direct quote to highlight unethical business practices.", "function": "expose_contradiction", "rawType": "expose_contradiction", "block": null, "metadata": { "slideType": "expose_contradiction", "slideTypeCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-124c-75aa-984a-0a3d0d8fc8df", "version": 1, "description": null }, "function": "expose_contradiction", "functionCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-171f-776f-887c-73edaff4cf9c", "version": 1, "description": null }, "density": "dense", "densityScore": 50, "componentCount": 5, "textChars": 3124, "nDataPoints": 0, "notes": "The slide uses a combination of summary text and a direct quote to highlight unethical business practices.", "elementsJson": [ "paragraph", "quote_block", "footnote" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 21:25:51.598+00", "seconds": 3.551, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/255", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-255", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "When the center delayed payment, the executive alleged that members of TransMedics management team – COO Tamer Khayal and OCS liver head Magdy Attia – attempted to pressure them for payment by holding a heart hostage from an ICU transplant patient", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:19+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a985-d2ce1dd10c9c", "parentComponentId": null }, { "bbox": { "h": 0.35, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "paragraph", "text": "An administrator at a pre-eminent, high-volume center detailed a pattern of “ridiculous” air transport charges with no invoice transparency, which were not part of any contract – involving multiple aircraft sent for a single recovery, allegedly resulting in charges of several hundred thousand dollars. When the center delayed payment, the executive alleged that members of TransMedics management team – COO Tamer Khayal and OCS liver head Magdy Attia – attempted to pressure them for payment by holding a heart hostage from an ICU transplant patient – “I hate flying their team all over the fucking country. I hate it. I hate paying for private jets...I don’t know why we have to pay for all these ridiculous transportation invoices...they just started flying their teams and then sending us these invoices...there’s very little transparency...we just get a piece of paper...it’s just a number...they could have made it up.”", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:25:51.598+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "4dd803b3-f7bf-4a24-84ed-cd870135410c", "parentComponentId": null }, { "bbox": { "h": 0.45, "w": 0.86, "x": 0.07, "y": 0.45 }, "kind": "quote", "text": "“I hate flying their team all over the fucking country”; sending extortionate invoices with no transparency\n“Now, I don’t even bother. I would never even attempt to negotiate anything with them because they won’t negotiate. The transportation is a major problem for us. Part of the reason why our PO took so long to execute is because they just created their own transportation company and started flying - I hate flying their team all over the fucking country. I hate it. I hate paying for private jets to fly their surgeons all over. I don’t know why we have to pay for all these ridiculous transportation invoices. And I hate when, now that they’ve got their own transportation company, they just started flying their teams and then sending us invoices. We can’t just pay a random—we can’t pay for flights from a company that we’re not contracted with. They have all these outstanding flight invoices because we don’t have a contract with...there’s very little transparency. Contracting with them for the transportation felt ridiculous because they couldn’t tell us what the rates were. Basically, we just get a piece of paper, an invoice that says you owe us $20,000 for this flight going from here to here. It doesn’t say anything about what kind of aircraft it was, how long was it in the air—all this stuff. It’s just a number. They could have just made it up. I find that to be very frustrating.” - Administrator at a pre-eminent academic transplant center", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:25:51.598+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "53d094c3-4ce2-400b-98ba-2516dce077c4", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "“I hate flying their team all over the fucking country. I hate it. I hate paying for private jets...I don’t know why we have to pay for all these ridiculous transportation invoices...they just started flying their teams and then sending us these invoices...there’s very little transparency...we just get a piece of paper...it’s just a number...they could have made it up.” — Administrator at a pre-eminent academic transplant center", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:19+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a985-d7ae9c10ecf2", "parentComponentId": null }, { "bbox": { "h": 0.02, "w": 0.3, "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:25:51.598+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "8a679134-cdb6-4841-bad1-886d79af460c", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [], "arcBeats": [], "loops": [], "locked": true }, { "page": 256, "type": "tension", "title": "The slide uses a Q&A transcript format to substantiate a serious allegation of unethical business practices.", "function": "expose_contradiction", "rawType": "expose_contradiction", "block": null, "metadata": { "slideType": "expose_contradiction", "slideTypeCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-124c-75aa-984a-0a3d0d8fc8df", "version": 1, "description": null }, "function": "expose_contradiction", "functionCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-171f-776f-887c-73edaff4cf9c", "version": 1, "description": null }, "density": "dense", "densityScore": 65, "componentCount": 7, "textChars": 3832, "nDataPoints": 0, "notes": "The slide uses a Q&A transcript format to substantiate a serious allegation of unethical business practices.", "elementsJson": [ "paragraph", "quote_block", "footnote" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 21:25:52.604+00", "seconds": 4.375, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/256", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-256", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "I cannot stand working with them...it feels like I’m talking to a used car salesman...we had a recent situation, where we had some A/R...they declined a heart transplant for one of our patients in the ICU.", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:20+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a987-0d6066b87282", "parentComponentId": null }, { "bbox": { "h": 0.35, "w": 0.86, "x": 0.07, "y": 0.16 }, "kind": "paragraph", "text": "Given the severity of the allegation, we confirmed the details with a second source, an executive at an OPO who was privy to the situation. The administrator voiced outrage: \"I cannot stand working with them...it feels like I’m talking to a used car salesman...we had a recent situation, where we had some A/R...they declined a heart transplant for one of our patients in the ICU...they refused to...get the heart for us...I could not believe it...I had to spend eight hours...trying to beg and plead with them to release the hold because we didn't want to miss an opportunity to get an organ for one of our patients...I was groveling...this person is in the ICU...they're going to die...they're status one...the sickest patient in need of an organ, and TransMedics made that call...it was their COO, Tamer Khayal, who is not a clinician...a used car salesman...[Magdy Attia] was part of the people threatening us.\"", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:25:52.604+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "5a458995-2fc2-4cef-9f58-3ab7f6a2f631", "parentComponentId": null }, { "bbox": { "h": 0.38, "w": 0.86, "x": 0.07, "y": 0.57 }, "kind": "quote", "text": "A: \"Me, personally, I cannot stand working with them. It feels like I'm talking to a used car salesman. I don't talk to their founders as much as I used . We had a recent situation, where we had some A/R...they declined a heart transplant for one of our patients in the ICU because of this credit hold. They refused to go out and get the heart for us. I could not believe it. They eventually agreed that the majority of the invoices were liver, so they released the heart and lung programs from the hold, but they were going to hold the liver program until we paid all of our invoices. I had to spend probably eight hours of my week on the phone with their rep, trying to beg and plead with them to release the hold because we didn't want to miss an opportunity to get an organ for one of our patients. It was very frustrating. I felt like I was groveling. The whole thing was a terrible experience.\"\nQ: \"So, they put a patient's life at risk, essentially.\"\nA: \"Yes. These heart patients, this isn't like a kidney transplant. This person is in the ICU. They're going to die. They're status one. They're getting this organ because they're the sickest patient in need of one, and TransMedics made that call. It was their COO, Tamer Khayal, who is not a clinician, who is the person that I find the most challenging to work with, like a used car salesman.\"\nQ: \"There's this other Egyptian guy named Magdy Attia who interacts with surgeons, and I've heard that surgeons sometimes have said that they don't want to take an organ, and he's badgering them to take it, telling them it's okay. Have you heard that?\"\nA: \"Yeah. He was part of this whole week where I was scrambling - he was part of the people threatening us.\" – Transplant administrator", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:25:52.604+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "eb7fab40-99a1-426f-87f1-6f36f0943ea3", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "I cannot stand working with them...it feels like I’m talking to a used car salesman...they declined a heart transplant for one of our patients in the ICU because of this credit hold. I had to spend probably eight hours of my week on the phone with their rep, trying to beg and plead with them to release the hold because we didn't want to miss an opportunity to get an organ for one of our patients. I was groveling. The whole thing was a terrible experience. ... It was their COO, Tamer Khayal, who is not a clinician, who is the person that I find the most challenging to work with, like a used car salesman. ... He was part of this whole week where I was scrambling - he was part of the people threatening us. — Transplant administrator", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:20+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a987-100ac17960ec", "parentComponentId": null }, { "bbox": { "h": 0.02, "w": 0.25, "x": 0.07, "y": 0.96 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:25:52.604+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "4d349cc1-05f5-466a-817b-4be678047a7b", "parentComponentId": null }, { "bbox": { "h": 0.08, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "title", "text": "The administrator stated that TransMedics then denied a heart to a status one patient, when payment for suspect invoices was not forthcoming.", "attrs": null, "canon": { "kind": { "name": "Title", "slug": "title", "status": "active", "canonId": "019de52c-f7dd-76d9-b848-b1f12bd85cf4", "version": 1, "description": "Slide title or headline." }, "tool": null, "subkind": { "name": "Headline", "slug": "headline", "status": "active", "canonId": "019de52c-fae1-7463-9a7c-d60668eced0d", "version": 1, "description": null }, "framework": null }, "subkind": "headline", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:25:52.604+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "c76f0f7c-48c4-4486-86ab-d4c54cb1e5d9", "parentComponentId": null }, { "bbox": { "h": 0.02, "w": 0.25, "x": 0.07, "y": 0.54 }, "kind": "title", "text": "COO allegedly held a heart hostage", "attrs": null, "canon": { "kind": { "name": "Title", "slug": "title", "status": "active", "canonId": "019de52c-f7dd-76d9-b848-b1f12bd85cf4", "version": 1, "description": "Slide title or headline." }, "tool": null, "subkind": { "name": "Subtitle", "slug": "subtitle", "status": "active", "canonId": "019de52c-fb09-739d-900c-815b0d9ac526", "version": 1, "description": null }, "framework": null }, "subkind": "subtitle", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:25:52.604+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "c97a3ad3-b03b-4372-a876-99d9ddbdae4c", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [], "arcBeats": [], "loops": [], "locked": true }, { "page": 257, "type": "tension", "title": "The slide uses verbatim interview transcripts to substantiate claims of extortion and unprofessional conduct by specific named executives.", "function": "name_villain", "rawType": "villain_critique", "block": null, "metadata": { "slideType": "villain_critique", "slideTypeCanon": { "name": "Villain critique", "slug": "villain_critique", "status": "active", "canonId": "019de52d-10bc-7136-bf20-09de59d17447", "version": 1, "description": null }, "function": "name_villain", "functionCanon": { "name": "Name villain", "slug": "name_villain", "status": "active", "canonId": "019de52d-1746-70d6-bc58-5eeaf5865526", "version": 1, "description": null }, "density": "balanced", "densityScore": 28, "componentCount": 2, "textChars": 1278, "nDataPoints": null, "notes": "The slide uses verbatim interview transcripts to substantiate claims of extortion and unprofessional conduct by specific named executives.", "elementsJson": [ "paragraph", "quote_block", "footnote" ], "confidence": null, "extraction": { "model": "unknown-legacy", "runId": null, "at": "2026-04-22 23:46:19+00", "seconds": null, "promptVersion": null } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/257", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-257", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "CEO/COO \"play hardball\" and alienated surgeons who now use other perfusion machines", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:19+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a986-58ecf70419fd", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "\"Typically, this is not how companies behave with somebody who helped them get FDA approval - one of the investigators, essentially. It's very unusual. We're a very high-volume user but that's Waleed's method, he and Tamar Khayal, his COO....that's how they roll. They play hardball. They've really alienated a lot of people and a lot of my friends have said, 'No way, I'm not ever using those guys because of the way they do business.' And my friends, of course...they're using OrganOX, and they're doing fine, and they're happy with their volume.\" — Transplant surgeon at a high-volume academic center; \"I get badgered very regularly by their medical director - their director of surgeons. My impression is that he's getting badgered by Waleed and Tamer to get our institution in line because he seems uncomfortable when he's talking to me. But I get badgered constantly about it. Can you check on the contract? What's going on? And then, when I call him to say, why are you sending a team from [redacted city] when you have a team in [redacted city]? That makes no sense. And you can see the logic is so flawed; he just talks in circles.\" — Transplant surgeon at a high-volume academic center", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:19+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a986-5f77caec9fb2", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [], "arcBeats": [], "loops": [], "locked": true }, { "page": 258, "type": "tension", "title": "The slide uses a Q&A transcript format to highlight negative sentiment regarding company culture and sales practices.", "function": "expose_contradiction", "rawType": "testimonial", "block": null, "metadata": { "slideType": "testimonial", "slideTypeCanon": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52d-0a2d-7782-8a48-7e84df92cc97", "version": 1, "description": null }, "function": "expose_contradiction", "functionCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-171f-776f-887c-73edaff4cf9c", "version": 1, "description": null }, "density": "dense", "densityScore": 53, "componentCount": 6, "textChars": 2505, "nDataPoints": 0, "notes": "The slide uses a Q&A transcript format to highlight negative sentiment regarding company culture and sales practices.", "elementsJson": [ "paragraph", "quote_block", "footnote" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 21:25:52.063+00", "seconds": 3.531, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/258", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-258", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "I would call him Waleed’s enforcer...he’s someone you wouldn’t be surprised to find out is knee-capping people...Tamer’s just going to tell you...‘this is how it’s going to be’...and you’re going to like it, and if you cause any trouble, I’m going to keep you in line...those movies where the guys go around and collect the protection money...that’s what he reminds me of - the guy who’s going around to collect the protection money.", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:19+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a986-9c5f54577dd3", "parentComponentId": null }, { "bbox": { "h": 0.45, "w": 0.86, "x": 0.07, "y": 0.4 }, "kind": "paragraph", "text": "Q: “You said they make it more expensive if you don’t use their air transport?”\nA: “Right.”\nQ: “I was shocked to hear some examples of their sending two planes - that they don’t really provide any visibility on the invoice. And I heard a lot about bullying by the COO, Tamer Khayal. And you mentioned Magdy Attia. Have you had interactions with Tamer Khayal?”\nA: “Yes.”\nQ: “And what was the interaction with him like?”\nA: “[Chuckles] I would call him Waleed’s enforcer. He’s someone you wouldn’t be surprised to find out is knee-capping people.”\nQ: “What is he doing or saying?”\nA: “He’s a very intense guy. Tamer’s just going to tell you, ‘Take it or leave it, this is how it’s going to be, you’ll pay our fees.’ He’s not trying to work with you. He’s not trying to schmooze you. He’s trying to just tell you you’re going to get what you get, and you’re going to like it, and if you cause any trouble, I’m going to keep you in line - that kind of thing. You see those movies where the guys go around and collect their protection money. That’s what he reminds me of - the guy who’s going around to collect the protection money.” - Transplant surgeon at a high-volume academic center", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:25:52.063+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "5deef6eb-53d4-44ec-b237-f65b67b2b90b", "parentComponentId": null }, { "bbox": { "h": 0.25, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "paragraph", "text": "The surgeon stated that the “hardball” reminded him of a protection racket in a Mafia movie, speaking of TransMedics Chief Commercial Officer Tamer Khayal: “I would call him Waleed’s enforcer...he’s someone you wouldn’t be surprised to find out is knee-capping people...he’s a very intense guy...Tamer’s just going to tell you...’this is how it’s going to be’...and you’re going to like it, and if you cause any trouble, I’m going to keep you in line...those movies where the guys go around and collect the protection money...that’s what he reminds me of - the guy who’s going around to collect the protection money.”", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:25:52.063+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "61588d35-3144-4921-a739-535a9e5a473a", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "“I would call him Waleed’s enforcer. He’s someone you wouldn’t be surprised to find out is knee-capping people.” — Transplant surgeon at a high-volume academic center", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:19+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a986-a1b297f4f2b7", "parentComponentId": null }, { "bbox": { "h": 0.02, "w": 0.25, "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:25:52.063+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "46c6af28-c47b-406d-b4bf-d54f495f377e", "parentComponentId": null }, { "bbox": { "h": 0.02, "w": 0.45, "x": 0.07, "y": 0.37 }, "kind": "title", "text": "CCO reminds high-volume user of a protection racket", "attrs": null, "canon": { "kind": { "name": "Title", "slug": "title", "status": "active", "canonId": "019de52c-f7dd-76d9-b848-b1f12bd85cf4", "version": 1, "description": "Slide title or headline." }, "tool": null, "subkind": { "name": "Action title", "slug": "action-title", "status": "active", "canonId": "019de52c-fb31-734c-a0f5-a3935b73135d", "version": 1, "description": null }, "framework": null }, "subkind": "action-title", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:25:52.063+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "19e16bfb-9721-44e0-9717-f35d5e2d138f", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [], "arcBeats": [], "loops": [], "locked": true }, { "page": 259, "type": "tension", "title": "The slide uses a Q&A format to document allegations of unethical sales pressure by a specific individual (Magdy Attia) at TransMedics.", "function": "expose_contradiction", "rawType": "expose_contradiction", "block": null, "metadata": { "slideType": "expose_contradiction", "slideTypeCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-124c-75aa-984a-0a3d0d8fc8df", "version": 1, "description": null }, "function": "expose_contradiction", "functionCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-171f-776f-887c-73edaff4cf9c", "version": 1, "description": null }, "density": "balanced", "densityScore": 49, "componentCount": 5, "textChars": 3087, "nDataPoints": 0, "notes": "The slide uses a Q&A format to document allegations of unethical sales pressure by a specific individual (Magdy Attia) at TransMedics.", "elementsJson": [ "paragraph", "quote_block", "footnote" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 21:25:52.239+00", "seconds": 3.66, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/259", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-259", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "they might push you and say, well, I think this liver is fine, you should use it... they are pushy...they’re a pushy company...they will say ‘I think this liver is going to work...I think it’s usable...you should use it...it’s their medical director, Attia...they lose the money...so they try really hard not to lose organs.”", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:19+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a986-b51866cee0cd", "parentComponentId": null }, { "bbox": { "h": 0.38, "w": 0.86, "x": 0.07, "y": 0.55 }, "kind": "list", "text": "Pressuring surgeons to use organs even if surgeons reject them\nA: “If you decide you don’t want to use a liver, like it’s been on the device a while and you’ve got it back at your center, they might push you and say, well, I think the liver is fine, you should use it...they are pushy. They’re a pushy company.”\nQ: “So, they’re pushing you to use a liver that, in your judgment as a surgeon, your initial reaction is, I don’t want to use it?”\nA: “Yeah, I would say they’re encouraging it for sure. But ultimately, you get to say no but yeah, they will say, “I think this liver is going to work. I think it’s going to be fine. It’s usable. You should use it.”\nQ: “The surgeons don’t seem like they would be that commercial. Who is pushing it?”\nA: “It’s the medical director, Attia, who might say this liver is going to be fine. I think you should use it. Of course, the typical qualifying statement, but it’s up to you. It’s up to you.”\nQ: “And if you don’t use it, is there a cost? Who absorbs the cost if the liver is not used? They went up there, they put it on the device with a disposable. They lose money, or do you still get charged for it?”\nA: “They lose money. You have to pay for the transportation and everything, but they lose the money. So, they try really hard not to lose organs…” - Transplant surgeon at a high-volume academic center", "attrs": null, "canon": { "kind": { "name": "List", "slug": "list", "status": "active", "canonId": "019de52c-f94b-779b-a53b-fd4904a5f4d2", "version": 1, "description": "Bullet or numbered list." }, "tool": null, "subkind": { "name": "Bullet list", "slug": "bullet", "status": "active", "canonId": "019de52c-fc98-7169-a083-5cab805076ca", "version": 1, "description": null }, "framework": null }, "subkind": "bullet", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:25:52.239+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "13e9f76b-4af5-4171-ac42-3e40eaf60f76", "parentComponentId": null }, { "bbox": { "h": 0.45, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "paragraph", "text": "The surgeon noted badgering and car salesman-type pressure by Magdy Attia to accept suspect organs that he thought may fail, due to excessive time lingering on the pump or other reasons – as TransMedics would lose the device revenue if the organ is rejected. Attia is an Egyptian import by way of the UK who appears to be unlicensed to practice medicine in the US, yet seems to do exactly that with customers referring to him as the “medical director.” His LinkedIn bio states his official role is “Chief of OCS Liver Transplant program at TransMedics,” in addition to apparently overseeing its procurement surgeons. The surgeon described the squeeze: “they might push you and say, well, I think this liver is fine, you should use it... they are pushy...they’re a pushy company...they will say ‘I think this liver is going to work...I think it’s usable...you should use it...it’s their medical director, Attia...they lose the money...so they try really hard not to lose organs.”", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:25:52.239+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "fc8563bb-db98-495d-b701-cd787ada82c2", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "“they might push you and say, well, I think this liver is fine, you should use it... they are pushy...they’re a pushy company...they will say ‘I think this liver is going to work...I think it’s usable...you should use it...it’s their medical director, Attia...they lose the money...so they try really hard not to lose organs.” — Transplant surgeon at a high-volume academic center", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:19+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a986-b832c7b66758", "parentComponentId": null }, { "bbox": { "h": 0.02, "w": 0.25, "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:25:52.239+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "0b6ffda0-0a9c-4486-9423-eb8e7c1a2670", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [], "arcBeats": [], "loops": [], "locked": true }, { "page": 260, "type": "tension", "title": "The slide uses a Q&A format to build a case against the company's business practices.", "function": "expose_contradiction", "rawType": "expose_contradiction", "block": null, "metadata": { "slideType": "expose_contradiction", "slideTypeCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-124c-75aa-984a-0a3d0d8fc8df", "version": 1, "description": null }, "function": "expose_contradiction", "functionCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-171f-776f-887c-73edaff4cf9c", "version": 1, "description": null }, "density": "dense", "densityScore": 70, "componentCount": 8, "textChars": 2816, "nDataPoints": 0, "notes": "The slide uses a Q&A format to build a case against the company's business practices.", "elementsJson": [ "paragraph", "quote_block" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 21:25:52.806+00", "seconds": 4.093, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/260", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-260", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "A good word to describe the company is top-down aggressive...there's no question....", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:19+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a986-8908d5361bac", "parentComponentId": null }, { "bbox": { "h": 0.23, "w": 0.86, "x": 0.07, "y": 0.69 }, "kind": "paragraph", "text": "Chief of OCS Liver program is allegedly unlicensed to practice medicine but engaging in the practice of medicine\nQ: “Is Attia the person who’s calling centers and doctors and saying you have to use this liver even if they don’t want to?”\nA: “He is the person that would call, yes.”\nQ: “And he’s engaging in a clinical conversation?”\nA: “Yes.”\nQ: “I heard he’s not even licensed to practice medicine in the U.S.”\nA: “That’s probably true. Yeah, he’s from the UK. He definitely oversteps at times. But again, I think that’s par for the course with the company. I think that’s their personality from the top down.” - Transplant surgeon at a high-volume academic center", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:25:52.806+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "01aa61ba-53aa-42e0-88fe-ad4cabc17fbf", "parentComponentId": null }, { "bbox": { "h": 0.18, "w": 0.86, "x": 0.07, "y": 0.31 }, "kind": "paragraph", "text": "Q: “When they’re badgering people, particularly smaller centers where they have a less confident surgeon or administrator - what percentage of the time do you think they’re badgering people into using an organ they don’t want to use?”\nA: “That’s a good question. I have enough experience that I’m confident, but I would imagine somebody who’s a new user, yeah, I can see that happening. I couldn’t give you a percentage, though, but I could definitely see that happening. Like I said, I get a lot of phone calls from people around the country saying, here’s what’s going on. Do you think I should use it? Or do you think it’s going to be okay, or what should I do? I get a lot of those texts and calls.”", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:25:52.806+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "1944d1c1-160f-429b-b913-0fb151554e60", "parentComponentId": null }, { "bbox": { "h": 0.18, "w": 0.86, "x": 0.07, "y": 0.5 }, "kind": "paragraph", "text": "Q: “From new users or just people that use the device?”\nA: “Yeah. New users and people with less experience using marginal organs that they know we’re using. A lot of calls from friends and acquaintances around the country.”\nQ: “A former employee that I talked to said that their procuring surgeons would sometimes, in their judgment, say we should not use this liver, and they’re basically told it’s perfectly good; go ahead.”\nA: “A good word to describe the company is top-down aggressive. There’s no question they’re aggressive.” - Transplant surgeon at a high-volume academic center", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:25:52.806+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "2ccf6000-14d8-49b9-8efc-0d38767d43c5", "parentComponentId": null }, { "bbox": { "h": 0.18, "w": 0.86, "x": 0.07, "y": 0.08 }, "kind": "paragraph", "text": "The surgeon stated that although he is experienced and confident enough to assess organs, that smaller centers – typically TransMedics highest users – are more vulnerable to the badgering to accept bad organs...", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:25:52.806+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "a1ff1f0b-e02f-49f6-9acb-67509e4b4eb1", "parentComponentId": null }, { "bbox": { "h": 0.02, "w": 0.45, "x": 0.07, "y": 0.28 }, "kind": "paragraph", "text": "Allegedly pressuring smaller centers into using questionable organs", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:25:52.806+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "c2847589-bafd-4c2e-a900-2e95e04efe9a", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "I could definitely see that happening...I get a lot of phone calls and texts from people around the country saying...do you think I should use it...what should I do...I get a lot of those texts and calls...[from] new users and people with less experience using marginal organs that they know we're using...a good word to describe the company is top-down aggressive...there's no question.... — Transplant surgeon at a high-volume academic center", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:19+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a986-8c8fd5022e72", "parentComponentId": null }, { "bbox": { "h": 0.02, "w": 0.25, "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:25:52.806+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "55d5aa76-3cc6-41a0-b79c-d84e44169b40", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [], "arcBeats": [], "loops": [], "locked": true }, { "page": 261, "type": "tension", "title": "The slide uses a Q&A format to highlight potential malpractice and coercion.", "function": "expose_contradiction", "rawType": "expose_contradiction", "block": null, "metadata": { "slideType": "expose_contradiction", "slideTypeCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-124c-75aa-984a-0a3d0d8fc8df", "version": 1, "description": null }, "function": "expose_contradiction", "functionCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-171f-776f-887c-73edaff4cf9c", "version": 1, "description": null }, "density": "overcrowded", "densityScore": 78, "componentCount": 9, "textChars": 2815, "nDataPoints": 0, "notes": "The slide uses a Q&A format to highlight potential malpractice and coercion.", "elementsJson": [ "paragraph", "quote_block" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 21:25:58.006+00", "seconds": 8.132, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/261", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-261", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "Other surgeons provided alarming examples suggestive of coercion and concealment of adverse information about organs - by senior TransMedics management, notably Magdy Attia, the “Medical Director” and Chief of the Liver Program - who, we repeat, appears to be unlicensed to practice medicine in the US.", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:20+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a986-fb866c317bb6", "parentComponentId": null }, { "bbox": { "h": 0.06, "w": 0.86, "x": 0.07, "y": 0.74 }, "kind": "list", "text": "Q: \"I've heard that from other people where there's a liver and it's a marginal with an issue and you don't want to use it. And the transplant surgeon's getting badgered. One of the surgeons called out Magdy Attia, who I don't even think is licensed to practice in the US. Walk me through some of that.\"", "attrs": null, "canon": { "kind": { "name": "List", "slug": "list", "status": "active", "canonId": "019de52c-f94b-779b-a53b-fd4904a5f4d2", "version": 1, "description": "Bullet or numbered list." }, "tool": null, "subkind": { "name": "Bullet list", "slug": "bullet", "status": "active", "canonId": "019de52c-fc98-7169-a083-5cab805076ca", "version": 1, "description": null }, "framework": null }, "subkind": "bullet", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:25:58.006+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "008130a0-5831-454a-8b45-04d7bb477ec4", "parentComponentId": null }, { "bbox": { "h": 0.12, "w": 0.86, "x": 0.07, "y": 0.8 }, "kind": "list", "text": "A: \"Magdy is the company spokesperson. He has to guide transplant surgeons because we're new at using this platform. What does it mean that the lactate went from .8 to 1? Is that concerning? In those situations, we'll call Magdy and say, \"What do you think about this?\" And he'll say maybe you should watch the liver for another couple of hours and then decide or no, we see that, I think it's going to be okay to use it. That's his job to be at all hours of the day and night, he's that point person.\" - Chief of transplant surgery at a major transplant center; high-volume TransMedics user", "attrs": null, "canon": { "kind": { "name": "List", "slug": "list", "status": "active", "canonId": "019de52c-f94b-779b-a53b-fd4904a5f4d2", "version": 1, "description": "Bullet or numbered list." }, "tool": null, "subkind": { "name": "Bullet list", "slug": "bullet", "status": "active", "canonId": "019de52c-fc98-7169-a083-5cab805076ca", "version": 1, "description": null }, "framework": null }, "subkind": "bullet", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:25:58.006+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "06ad3c71-8f1b-44dd-9dd8-55b7b7de2a92", "parentComponentId": null }, { "bbox": { "h": 0.08, "w": 0.86, "x": 0.07, "y": 0.66 }, "kind": "list", "text": "A: \"There have been some procurement issues. There has been some pressure; there has been pressure to use grafts when we don't like the way they're performing on the pump, but they lose out if we don't use the liver. We lose out if we don't use it - so there is a pressure to use some of these livers.\"", "attrs": null, "canon": { "kind": { "name": "List", "slug": "list", "status": "active", "canonId": "019de52c-f94b-779b-a53b-fd4904a5f4d2", "version": 1, "description": "Bullet or numbered list." }, "tool": null, "subkind": { "name": "Bullet list", "slug": "bullet", "status": "active", "canonId": "019de52c-fc98-7169-a083-5cab805076ca", "version": 1, "description": null }, "framework": null }, "subkind": "bullet", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:25:58.006+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "d2fab764-e5c8-40bf-be8f-9d01ed87f7b2", "parentComponentId": null }, { "bbox": { "h": 0.35, "w": 0.86, "x": 0.07, "y": 0.24 }, "kind": "paragraph", "text": "The Chief of transplant at a center in a major metropolitan area - a high-volume TransMedics user, although not for much longer - described \"procurement issues\" by the retrieval surgeons overseen by Attia...", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:25:58.006+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "af6ad5e4-eb56-4b70-be6d-cbade86e03f3", "parentComponentId": null }, { "bbox": { "h": 0.04, "w": 0.86, "x": 0.07, "y": 0.62 }, "kind": "quote", "text": "Pressure to use organs not performing on the pump; Attia appears to be engaging in practice of medicine", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:25:58.006+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "faa2c57f-2489-4a02-8a70-01dce5144a1a", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "“there has been pressure to use grafts when we don’t like the way they’re performing on the pump, but they lose out if we don’t use the liver...there is pressure to use some of these livers.”; “he has to guide transplant surgeons because we’re new at using this platform...what does it mean that the lactate went from .8 to 1? Is that concerning?...we’ll call Magdy and say ‘What do you think about this?’...he’ll say maybe you should watch the liver for another couple of hours....I think it’s going to be ok to use it...that’s his job to be on call at all hours...he’s that point person.” — Chief of transplant surgery at a major transplant center", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:20+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a986-fde45e877a47", "parentComponentId": null }, { "bbox": { "h": 0.02, "w": 0.3, "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:25:58.006+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "1ff731e4-7cae-4cbc-8240-439c97ff37ef", "parentComponentId": null }, { "bbox": { "h": 0.15, "w": 0.86, "x": 0.07, "y": 0.08 }, "kind": "title", "text": "Other surgeons provided alarming examples suggestive of coercion and concealment of adverse information about organs - by senior TransMedics management, notably Magdy Attia, the “Medical Director” and Chief of the Liver Program – who, we repeat, appears to be unlicensed to practice medicine in the US.", "attrs": null, "canon": { "kind": { "name": "Title", "slug": "title", "status": "active", "canonId": "019de52c-f7dd-76d9-b848-b1f12bd85cf4", "version": 1, "description": "Slide title or headline." }, "tool": null, "subkind": { "name": "Headline", "slug": "headline", "status": "active", "canonId": "019de52c-fae1-7463-9a7c-d60668eced0d", "version": 1, "description": null }, "framework": null }, "subkind": "headline", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:25:58.006+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "84b9ada4-09ca-49cc-930c-54560591e22e", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [], "arcBeats": [], "loops": [], "locked": true }, { "page": 262, "type": "tension", "title": "The slide presents a narrative of a specific medical failure involving a necrotic liver, alleging that TransMedics may be concealing damage from receiving cente", "function": "expose_contradiction", "rawType": "quote_slide", "block": null, "metadata": { "slideType": "quote_slide", "slideTypeCanon": { "name": "Quote slide", "slug": "quote_slide", "status": "active", "canonId": "019de52d-098e-7555-a9fd-4f0af7e80bc2", "version": 1, "description": null }, "function": "expose_contradiction", "functionCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-171f-776f-887c-73edaff4cf9c", "version": 1, "description": null }, "density": "balanced", "densityScore": 35, "componentCount": 5, "textChars": 1169, "nDataPoints": 0, "notes": "The slide presents a narrative of a specific medical failure involving a necrotic liver, alleging that TransMedics may be concealing damage from receiving centers.", "elementsJson": [ "paragraph", "quote_block" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 21:25:52.827+00", "seconds": 2.783, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/262", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-262", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "The surgeon indicated that the TransMedics retrieval surgeon was aware of the damage but withheld it - although, as indicated previously, TransMedics allegedly prevents them from communicating directly with receiving centers.", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:19+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a986-e457e2ef2ae0", "parentComponentId": null }, { "bbox": { "h": 0.65, "w": 0.86, "x": 0.07, "y": 0.08 }, "kind": "paragraph", "text": "The surgeon provided a recent example of a necrotic liver where “part of the right lobe of the liver was just completely dead” – which the surgeon then realized, after reaching out to colleagues around the US, is a prevalent issue.", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:25:52.827+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "824ca21e-2cda-49da-aa3b-e5ea87c713e9", "parentComponentId": null }, { "bbox": { "h": 0.25, "w": 0.86, "x": 0.07, "y": 0.68 }, "kind": "quote", "text": "A: “Examples where it hasn’t gone so great are situations where the liver is on pump. The numbers may be favorable but there’s something we don’t like about the liver. There was a liver a month ago where the right lobe felt very firm, like it was infarction, that part of it had died.”", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:25:52.827+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "6f6c66f5-5b0e-4862-a8f1-2606cbf74301", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "“Examples where it hasn't gone so great are situations where the liver is on pump. The numbers may be favorable but there's something we don't like about the liver. There was a liver a month ago where the right lobe felt very firm, like it was infarction, that part of it had died.” — Chief of transplant surgery at a major transplant center; high-volume TransMedics users", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:19+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a986-e9ff91f1ca81", "parentComponentId": null }, { "bbox": { "h": 0.02, "w": 0.3, "x": 0.07, "y": 0.97 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:25:52.827+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "e2a5d5f4-92ed-4416-ac22-d19f10bd4239", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [ { "matchId": "1bb07d58-5930-44c8-9cf9-ea3453623323", "evidence": "The slide contrasts favorable pump numbers with the reality of a necrotic liver, suggesting a systemic issue.", "framework": null, "confidence": 0.8, "extraction": { "at": "2026-05-02 21:25:52.827+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 262, "frameworkName": "ceo-quote-contradiction" } ], "arcBeats": [], "loops": [], "locked": true }, { "page": 263, "type": "tension", "title": "The slide uses a Q&A format to highlight a specific allegation of corporate dishonesty.", "function": "expose_contradiction", "rawType": "expose_contradiction", "block": null, "metadata": { "slideType": "expose_contradiction", "slideTypeCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-124c-75aa-984a-0a3d0d8fc8df", "version": 1, "description": null }, "function": "expose_contradiction", "functionCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-171f-776f-887c-73edaff4cf9c", "version": 1, "description": null }, "density": "dense", "densityScore": 56, "componentCount": 7, "textChars": 1660, "nDataPoints": 0, "notes": "The slide uses a Q&A format to highlight a specific allegation of corporate dishonesty.", "elementsJson": [ "paragraph", "quote_block" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 21:25:53.901+00", "seconds": 3.577, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/263", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-263", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": { "h": 0.03, "w": 0.86, "x": 0.07, "y": 0.6 }, "kind": "callout", "text": "Failed to report liver was necroscopic; TransMedics allegedly lied to the center to cover up a prevalent issue", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": null, "subkind": { "name": "Primary callout", "slug": "primary", "status": "active", "canonId": "019de52c-fbd1-70eb-a9ce-8997f8674c1d", "version": 1, "description": null }, "framework": null }, "subkind": "primary", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:25:53.901+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "7a4d2e22-b7ee-49d6-a63e-52e164d3183d", "parentComponentId": null }, { "bbox": null, "kind": "callout", "text": "TransMedics allegedly lied to the center to cover up a prevalent issue", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:20+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a987-4f515e18342b", "parentComponentId": null }, { "bbox": { "h": 0.52, "w": 0.86, "x": 0.07, "y": 0.08 }, "kind": "paragraph", "text": "The surgeon stated that TransMedics was fully aware that part of the liver was dead, and that they recently encountered another necrotic liver, just weeks after the other one – and that their “Medical Director” Magdy Attia falsely told them they were the only center that had encountered the issue.", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:25:53.901+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "d04340b2-3937-4cdf-b795-8cf436979389", "parentComponentId": null }, { "bbox": { "h": 0.08, "w": 0.86, "x": 0.07, "y": 0.64 }, "kind": "quote", "text": "Q: “So, when you got the liver, you didn’t even know until you felt it and they didn’t tell you?” A: “Until after we felt it, exactly. So, there was an issue and then the liver, the pump - we reported this to TransMedics and we were right. Our concerns were correct.”", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:25:53.901+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "9fce64db-4f78-447e-9da9-022a26b14e57", "parentComponentId": null }, { "bbox": { "h": 0.18, "w": 0.86, "x": 0.07, "y": 0.73 }, "kind": "quote", "text": "Q: “Was this the kind of thing that should have been obvious to the procuring surgeon just by feeling it?” A: “The procuring surgeon could feel it, but it was not reported... Fast forward three weeks later... the right lobe of the liver fell off... the response was ‘Wow, yours is the only center that is having these issues,’ which is an outright lie. There were other centers that definitely had concerns about a graft and how it felt before implantation.”", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:25:53.901+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "fb6f66e8-0e75-4133-8146-733811f5f1cf", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "“Until after we felt it, exactly. So, there was an issue and then the liver, the pump - we reported this to TransMedics and we were right. Our concerns were correct... the right lobe of the liver fell off... the response was ‘Wow, yours is the only center that is having these issues,’ which is an outright lie.” — Chief of transplant surgery at a major transplant center; high-volume TransMedics user", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:20+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a987-53561b292779", "parentComponentId": null }, { "bbox": { "h": 0.02, "w": 0.3, "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:25:53.901+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "42fbcb04-6c05-4afd-95e3-6cb65532489e", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [ { "matchId": "7d91698c-2129-44db-a940-c34ac3379050", "evidence": "The slide explicitly frames the content as exposing a lie by the company to cover up a product defect.", "framework": null, "confidence": 0.9, "extraction": { "at": "2026-05-02 21:25:53.901+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 263, "frameworkName": "fraud-exposure" } ], "arcBeats": [], "loops": [], "locked": true }, { "page": 264, "type": "tension", "title": "The slide uses a Q&A format to highlight a perceived cover-up by the company regarding device performance.", "function": "expose_contradiction", "rawType": "expose_contradiction", "block": null, "metadata": { "slideType": "expose_contradiction", "slideTypeCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-124c-75aa-984a-0a3d0d8fc8df", "version": 1, "description": null }, "function": "expose_contradiction", "functionCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-171f-776f-887c-73edaff4cf9c", "version": 1, "description": null }, "density": "dense", "densityScore": 70, "componentCount": 8, "textChars": 2657, "nDataPoints": 0, "notes": "The slide uses a Q&A format to highlight a perceived cover-up by the company regarding device performance.", "elementsJson": [ "paragraph", "quote_block", "footnote" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 21:25:54.405+00", "seconds": 3.958, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/264", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-264", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "it's just a fucking lie...it's a lie that we're the only center that's having these problem but that was the communication to us....", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:20+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a987-353b0b3564fc", "parentComponentId": null }, { "bbox": { "h": 0.03, "w": 0.86, "x": 0.07, "y": 0.25 }, "kind": "paragraph", "text": "Failed to report liver was necroscopic; TransMedics allegedly lied to the center to cover up a prevalent issue", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:25:54.405+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "adaccc40-05ec-4df7-9c95-24f46d4bdfd0", "parentComponentId": null }, { "bbox": { "h": 0.15, "w": 0.86, "x": 0.07, "y": 0.29 }, "kind": "quote", "text": "A: “So, then their advice to us was, “Why don’t you wait a couple of hours,” which we did. And the right lobe still didn’t feel much better. So, we declined that liver. Fortunate for TransMedics, [transplant center redacted], our colleagues down the road, decided to use that liver for one of their patients. So, that liver did get transplanted. I don’t know what the outcome was for their patient but it left a bad taste in our mouth because we are trying to do what’s right by our patient and the feedback makes us feel like it’s something that we’re doing wrong in our assessment....the trust was fractured at that point.”", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:25:54.405+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "03462f8a-e145-484a-8e16-8c98c18c4115", "parentComponentId": null }, { "bbox": { "h": 0.25, "w": 0.86, "x": 0.07, "y": 0.48 }, "kind": "quote", "text": "A: “Magdy was the one who told us about that. So, then we called other colleagues around the nation. We called [redacted]; we called [redacted] - what do you guys think? And they said, ‘Oh, we’ve definitely seen this before. Sometimes it’s a procurement issue; sometimes it’s pressure on the pump. We’ve definitely seen that before.’ So, it’s just a fucking lie. It’s a lie that we’re the only center that’s having these problems but that was the communication to us. We don’t know what’s going on with you guys, but everyone else is fine using our pump. And this situation, we were like, “You know what? We’re not going to put our patient at risk. We’ll eat the cost, fine.” – Chief of transplant surgery at a major transplant center; high-volume TransMedics user", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:25:54.405+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "73c27d66-bcf3-4485-b15b-a7ea80f9d11a", "parentComponentId": null }, { "bbox": { "h": 0.02, "w": 0.86, "x": 0.07, "y": 0.45 }, "kind": "quote", "text": "Q: “Who was saying to you you’re the only center having this issue and lying? Was that Magdy Attia?”", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:25:54.405+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "e93cb839-811a-433a-aba9-fb297d10efbc", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "“So, then their advice to us was, ‘Why don’t you wait a couple of hours,’ which we did. And the right lobe still didn’t feel much better. So, we declined that liver... the trust was fractured at that point.”; “Magdy was the one who told us about that. So, then we called other colleagues around the nation... And they said, ‘Oh, we’ve definitely seen this before. Sometimes it’s a procurement issue; sometimes it’s pressure on the pump.’ So, it’s just a fucking lie. It’s a lie that we’re the only center that’s having these problems but that was the communication to us.” — Chief of transplant surgery at a major transplant center; high-volume TransMedics user", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:20+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a987-3b60a832c4cd", "parentComponentId": null }, { "bbox": { "h": 0.02, "w": 0.3, "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:25:54.405+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "b07869a8-090e-4626-a51e-5509d3f388ea", "parentComponentId": null }, { "bbox": { "h": 0.15, "w": 0.86, "x": 0.07, "y": 0.08 }, "kind": "title", "text": "The surgeon’s color implies a widespread issue with livers becoming necrotic on the device - a known risk and potentially fatal flaw with normothermic perfusion pumps - and suggests a conspiracy to cover it up", "attrs": null, "canon": { "kind": { "name": "Title", "slug": "title", "status": "active", "canonId": "019de52c-f7dd-76d9-b848-b1f12bd85cf4", "version": 1, "description": "Slide title or headline." }, "tool": null, "subkind": { "name": "Headline", "slug": "headline", "status": "active", "canonId": "019de52c-fae1-7463-9a7c-d60668eced0d", "version": 1, "description": null }, "framework": null }, "subkind": "headline", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:25:54.405+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "2b6d3d37-4aaa-46ad-b53e-c9118a5f3e4d", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [], "arcBeats": [], "loops": [], "locked": true }, { "page": 265, "type": "tension", "title": "The slide uses a quote to highlight a perceived lack of transparency by the company.", "function": "expose_contradiction", "rawType": "expose_contradiction", "block": null, "metadata": { "slideType": "expose_contradiction", "slideTypeCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-124c-75aa-984a-0a3d0d8fc8df", "version": 1, "description": null }, "function": "expose_contradiction", "functionCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-171f-776f-887c-73edaff4cf9c", "version": 1, "description": null }, "density": "balanced", "densityScore": 45, "componentCount": 5, "textChars": 1947, "nDataPoints": 0, "notes": "The slide uses a quote to highlight a perceived lack of transparency by the company.", "elementsJson": [ "paragraph", "quote_block", "footnote" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 21:25:53.423+00", "seconds": 2.701, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/265", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-265", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "TransMedics declined to publish that data...that is not being very honest...it's their responsibility....they should publish it and be forthcoming.", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:19+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a986-cd6525c85a03", "parentComponentId": null }, { "bbox": { "h": 0.25, "w": 0.86, "x": 0.07, "y": 0.08 }, "kind": "paragraph", "text": "The surgeon indicated that the two recent livers with necrotic tissue – and the fact that other centers are encountering the same issues – calls for the publication of data about device problems and outcomes, which TransMedics has allegedly refused: \"members of the transplant community, myself included, have called for publication of the livers that are not used or the complications related to livers that have been on the OCS pump, and they declined...TransMedics declined to publish that data...that is not being very honest...it's their responsibility....they should publish it and be forthcoming.\"", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:25:53.423+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "2ae16a10-f62b-4158-883a-7a5415b24171", "parentComponentId": null }, { "bbox": { "h": 0.15, "w": 0.86, "x": 0.07, "y": 0.39 }, "kind": "quote", "text": "TransMedics allegedly refusing to publish data on necrotic livers\n\"I can't speak to their outcomes overall. But I do know that there are members of the transplant community, myself included, have called for publication of the livers that are not used or the complications related to livers that have been on the OCS pump, and they declined. TransMedics declined to publish that data. Like that is not being very honest...it's their responsibility to vet their surgeons and they should publish it and be forthcoming.\" – Chief of transplant surgery at a major transplant center; high volume TransMedics user", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:25:53.423+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "e1e31734-ba60-48cc-9868-b7ef43329cf2", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "“I can't speak to their outcomes overall. But I do know that there are members of the transplant community, myself included, have called for publication of the livers that are not used or the complications related to livers that have been on OCS pump, and they declined. TransMedics declined to publish that data. Like that is not being very honest...it's their responsibility to vet their surgeons and they should publish it and be forthcoming.” — Chief of transplant surgery at a major transplant center; high volume TransMedics user", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:19+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a986-d2aa81261bfd", "parentComponentId": null }, { "bbox": { "h": 0.02, "w": 0.25, "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:25:53.423+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "eec53962-1eed-4913-81e8-55980e1076fb", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [ { "matchId": "2f036c3c-0c2e-45df-a235-f3b235e92dfe", "evidence": "The slide uses a direct quote from an expert to contradict the company's transparency/claims.", "framework": null, "confidence": 0.9, "extraction": { "at": "2026-05-02 21:25:53.423+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 265, "frameworkName": "ceo-quote-contradiction" } ], "arcBeats": [], "loops": [], "locked": true }, { "page": 266, "type": "tension", "title": "The slide uses direct quotes to characterize the CEO as 'arrogant' and the company's behavior as 'extortion' and 'aggressive'.", "function": "name_villain", "rawType": "villain_critique", "block": null, "metadata": { "slideType": "villain_critique", "slideTypeCanon": { "name": "Villain critique", "slug": "villain_critique", "status": "active", "canonId": "019de52d-10bc-7136-bf20-09de59d17447", "version": 1, "description": null }, "function": "name_villain", "functionCanon": { "name": "Name villain", "slug": "name_villain", "status": "active", "canonId": "019de52d-1746-70d6-bc58-5eeaf5865526", "version": 1, "description": null }, "density": "overcrowded", "densityScore": 85, "componentCount": 10, "textChars": 3944, "nDataPoints": 0, "notes": "The slide uses direct quotes to characterize the CEO as 'arrogant' and the company's behavior as 'extortion' and 'aggressive'.", "elementsJson": [ "paragraph", "quote_block" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 21:25:58.861+00", "seconds": 7.771, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/266", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-266", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": { "h": 0.03, "w": 0.86, "x": 0.07, "y": 0.68 }, "kind": "callout", "text": "Large OPO ceased working TransMedics; “putting people’s lives in jeopardy”", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": null, "subkind": { "name": "Primary callout", "slug": "primary", "status": "active", "canonId": "019de52c-fbd1-70eb-a9ce-8997f8674c1d", "version": 1, "description": null }, "framework": null }, "subkind": "primary", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:25:58.861+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "1c4094f0-992b-49e6-8a24-b47deb64f5cf", "parentComponentId": null }, { "bbox": { "h": 0.03, "w": 0.86, "x": 0.07, "y": 0.51 }, "kind": "callout", "text": "CEO viewed as “an arrogant price” due to “price gouging”; “people don’t like him”", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": null, "subkind": { "name": "Primary callout", "slug": "primary", "status": "active", "canonId": "019de52c-fbd1-70eb-a9ce-8997f8674c1d", "version": 1, "description": null }, "framework": null }, "subkind": "primary", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:25:58.861+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "8f03e78b-38fe-44e2-b5a9-4bc0e5d57311", "parentComponentId": null }, { "bbox": null, "kind": "callout", "text": "The CEO of a major OPO stated “their CEO is pretty arrogant...he’s an arrogant prick....I mean, look at what they did...they bought $12-13 million aircraft...it’s just price gouging...it’s unbelievable...it’s not what transplant is meant to be...people don’t like him.”", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:20+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a987-7ad2fd713bf3", "parentComponentId": null }, { "bbox": { "h": 0.15, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "paragraph", "text": "In addition to surgeons and transplant center administrators, executives at leading OPO's - organ procurement organizations – provided similar examples of hardball conduct suggestive of extortion, and exhibited the same animus toward TransMedics.", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:25:58.861+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "4619a930-4aa6-44a0-b184-b6653d8b351e", "parentComponentId": null }, { "bbox": { "h": 0.23, "w": 0.86, "x": 0.07, "y": 0.72 }, "kind": "quote", "text": "Q: “Some surgeons have used words like racket, mafia, and extortion to describe TransMedics when I spoke to them. I’m just quoting verbatim. It’s a complex space and I get the sense that they are engaging in some sketchy behavior through OPO’s.” A: “We were a customer and we bailed for these reasons... some of the business practices were starting to come to light that we didn’t agree with...I’ve been on a few calls with them. If you ask any questions, they are very aggressive and confrontational...what they charge for it and what they expect you to do to be able to have their blessing to use it is frankly putting people’s lives in jeopardy. It’s crazy. Personally, we did not agree with some of their business practices...the CEO was on the call... he just launched on me, threatening that if we didn’t want to work with them, then that’s fine. They could take their device elsewhere. I really don’t know how else to explain it. It was just very aggressive. They don’t like receiving questions or perceiving that they’re being questioned.” - Executive at a leading OPO, longtime industry veteran", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:25:58.861+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "28120883-ffa2-4260-9e14-f2f0574a8511", "parentComponentId": null }, { "bbox": { "h": 0.12, "w": 0.86, "x": 0.07, "y": 0.22 }, "kind": "quote", "text": "The CEO of a major OPO stated “their CEO is pretty arrogant...he’s an arrogant prick....I mean, look at what they did...they bought $12-13 million aircraft...it’s just price gouging...it’s unbelievable...it’s not what transplant is meant to be...people don’t like him.”", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:25:58.861+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "294f6459-acbf-4ad1-b0c0-3db23696161d", "parentComponentId": null }, { "bbox": { "h": 0.15, "w": 0.86, "x": 0.07, "y": 0.34 }, "kind": "quote", "text": "A second executive, at one of the largest OPO’s, stated they ceased working with the company after repeated cases of aggressive, improper behavior and described a volatile CEO: “we bailed for these reasons...the business practices were starting to come to light...if you ask any questions, they are very aggressive and confrontational...it is frankly putting people’s lives in jeopardy...it’s crazy...[Waleed] just launched on me...threatening that if we didn’t work with them...it was just very aggressive.”", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:25:58.861+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "76a519d1-841c-45ce-96d7-dddd4a6c6d4a", "parentComponentId": null }, { "bbox": { "h": 0.12, "w": 0.86, "x": 0.07, "y": 0.55 }, "kind": "quote", "text": "“Their CEO is pretty arrogant. He’s an arrogant prick. I mean, look at what they did. They bought $12-13 million aircraft. It’s beautiful, but guess what? It works just as well as a $2 million aircraft or lease the damn thing and have a reasonable logistics expense, but it’s just price gouging. It’s unbelievable. It’s not what transplant is meant to be. It’s not meant to be this crazy. I don’t care. Make your margin, crush it, but don’t withhold it and make it almost impossible to use your technology that’s going to help people just because you’re a prick. People don’t like him.” - CEO of a major OPO (Organ Procurement Organization), longtime industry executive", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:25:58.861+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "b0aa7a01-37ef-430d-9dee-c45ef15862b2", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "“Their CEO is pretty arrogant. He’s an arrogant prick. I mean, look at what they did. They bought $12-13 million aircraft. It’s beautiful, but guess what? It works just as well as a $2 million aircraft or lease the damn thing and have a reasonable logistics expense, but it’s just price gouging. It’s unbelievable. It’s not what transplant is meant to be. It’s not meant to be this crazy. I don’t care. Make your margin, crush it, but don’t withhold it and make it almost impossible to use your technology that’s going to help people just because you’re a prick. People don’t like him.” — CEO of a major OPO (Organ Procurement Organization), longtime industry executive", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:20+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a987-7f7548d7c5a0", "parentComponentId": null }, { "bbox": { "h": 0.02, "w": 0.3, "x": 0.07, "y": 0.96 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:25:58.861+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "386d7cb3-020c-4183-8c87-ec09be6714c3", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [], "arcBeats": [], "loops": [], "locked": true }, { "page": 267, "type": "tension", "title": "The slide uses a combination of summary text and direct interview transcripts to build a case of corporate misconduct.", "function": "expose_contradiction", "rawType": "expose_contradiction", "block": null, "metadata": { "slideType": "expose_contradiction", "slideTypeCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-124c-75aa-984a-0a3d0d8fc8df", "version": 1, "description": null }, "function": "expose_contradiction", "functionCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-171f-776f-887c-73edaff4cf9c", "version": 1, "description": null }, "density": "overcrowded", "densityScore": 79, "componentCount": 9, "textChars": 3219, "nDataPoints": 0, "notes": "The slide uses a combination of summary text and direct interview transcripts to build a case of corporate misconduct.", "elementsJson": [ "paragraph", "quote_block", "footnote" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 21:25:55.579+00", "seconds": 4.424, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/267", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-267", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "TransMedics will look you in the eye and say, we’re going to leave them in the body unless you pay us $3,000.", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:20+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a987-63584482b7bc", "parentComponentId": null }, { "bbox": { "h": 0.22, "w": 0.86, "x": 0.07, "y": 0.37 }, "kind": "paragraph", "text": "“The other thing they do - in the transplant community, often there are donors where seven organs get procured, but most of the time it's livers and kidneys. Historically, the liver team goes in and procures the liver for their patient and they're already. It takes an extra five minutes to recover the kidneys for transplant. I've been here for [redacted] years. This is just standard professional surgical courtesy. If you're on the liver team, you're going to spend a few hours dissecting the liver, procuring it for transplant, and by that point, the kidneys are almost detached from the body. You spend an extra five minutes - TransMedics, if they're sending their liver team, they won't do it. They blanketly just refuse to do it. For most OPOs out there, they tell them that if you want us to recover your kidneys, it's going to be $3000 - extortion.” – Executive at a leading OPO, longtime industry veteran", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:25:55.579+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "18647e86-e840-4a63-a745-ad276af450b1", "parentComponentId": null }, { "bbox": { "h": 0.03, "w": 0.86, "x": 0.07, "y": 0.33 }, "kind": "paragraph", "text": "Refusing to procure kidneys, standard practice; allegedly trying to extort another $3,000, “extortion”", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:25:55.579+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "82489b9c-1743-4fa6-9fea-29ded51f1963", "parentComponentId": null }, { "bbox": { "h": 0.18, "w": 0.86, "x": 0.07, "y": 0.65 }, "kind": "paragraph", "text": "A: “We're a non-profit. The kidney side of the operation is totally paid for by Medicare. So, we just refused that. Just to tell you about their business practices, it's all back and forth favors. Because we happened to credential one of their surgeons, we were able to negotiate that they recover the kidneys for us without these additional fees. But I know for a fact that they're charging the OPO in Sacramento or these other OPOs when they're in a bind because it's only the TransMedics surgeon present; they threaten to leave the kidneys in the body and risk two people not being able to come off dialysis because they want to charge these crazy fees.”", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:25:55.579+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "9de3bfba-7006-43e8-9755-b56e7df64219", "parentComponentId": null }, { "bbox": { "h": 0.03, "w": 0.86, "x": 0.07, "y": 0.61 }, "kind": "paragraph", "text": "“Back and forth favors”; “threaten to leave kidneys in the body and risk two people coming off dialysis”", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:25:55.579+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "cbe1ed33-1f2a-463e-bd54-fcef2ea4d9a2", "parentComponentId": null }, { "bbox": { "h": 0.12, "w": 0.86, "x": 0.07, "y": 0.83 }, "kind": "paragraph", "text": "Q: “You said standard operating procedure is a transplant surgeon goes to get the liver, and at the end, it's an extra five minutes and $3000 to get the kidneys. So, just out of professional courtesy, every procurement team does that. Their surgeon won't do that, so they're forcing people to send a whole other team?”\nA: “It's standard courtesy, and Medicare tells us that what we can pay for that surgical service, $625 per kidney, so $1250 for the two. TransMedics will look you in the eye and say, we're going to leave them in the body unless you pay us $3,000.” – Executive at a leading OPO, longtime industry veteran", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:25:55.579+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "d0a265bb-bbe2-4abd-8e88-a9ec28a46ef3", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "“if they’re sending their liver team...they just blanketly refuse to do it...they tell them if you want us to recover your kidneys, it’s going to be $3,000 - extortion....just to tell you about their business practices, it’s all back and forth favors...they threaten to leave the kidneys in the body and risk two people not being able to come off dialysis because they want to charge these crazy fees.” — Executive at a leading OPO, longtime industry veteran", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:20+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a987-67f614deaf56", "parentComponentId": null }, { "bbox": { "h": 0.02, "w": 0.25, "x": 0.07, "y": 0.96 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:25:55.579+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "b1b346fd-8706-4f44-9592-48620e413a72", "parentComponentId": null }, { "bbox": { "h": 0.25, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "title", "text": "The OPO executive detailed particularly disturbing behavior where TransMedics allegedly threatens to leave organs such as kidneys in a donor body unless paid double the Medicare rate for extraction", "attrs": null, "canon": { "kind": { "name": "Title", "slug": "title", "status": "active", "canonId": "019de52c-f7dd-76d9-b848-b1f12bd85cf4", "version": 1, "description": "Slide title or headline." }, "tool": null, "subkind": { "name": "Headline", "slug": "headline", "status": "active", "canonId": "019de52c-fae1-7463-9a7c-d60668eced0d", "version": 1, "description": null }, "framework": null }, "subkind": "headline", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:25:55.579+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "844a8ab8-8eb5-48a7-aded-555b03f06f5e", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [ { "matchId": "f4905bc4-95b4-493f-875a-65f18875ec61", "evidence": "The slide explicitly frames the narrative as exposing unethical and potentially illegal business practices (extortion).", "framework": null, "confidence": 0.9, "extraction": { "at": "2026-05-02 21:25:55.579+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 267, "frameworkName": "fraud-exposure" } ], "arcBeats": [], "loops": [], "locked": true }, { "page": 268, "type": "tension", "title": "The slide presents a narrative of professional misconduct and coercion within an organ procurement organization.", "function": "expose_contradiction", "rawType": "expose_contradiction", "block": null, "metadata": { "slideType": "expose_contradiction", "slideTypeCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-124c-75aa-984a-0a3d0d8fc8df", "version": 1, "description": null }, "function": "expose_contradiction", "functionCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-171f-776f-887c-73edaff4cf9c", "version": 1, "description": null }, "density": "dense", "densityScore": 57, "componentCount": 6, "textChars": 4405, "nDataPoints": 0, "notes": "The slide presents a narrative of professional misconduct and coercion within an organ procurement organization.", "elementsJson": [ "paragraph", "quote_block", "footnote" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 21:25:56.108+00", "seconds": 4.324, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/268", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-268", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": { "h": 0.03, "w": 0.45, "x": 0.07, "y": 0.58 }, "kind": "callout", "text": "CEO's sister allegedly badgering people to transplant defective lungs", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": null, "subkind": { "name": "Primary callout", "slug": "primary", "status": "active", "canonId": "019de52c-fbd1-70eb-a9ce-8997f8674c1d", "version": 1, "description": null }, "framework": null }, "subkind": "primary", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:25:56.108+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "dc880360-6d68-4cea-8380-ffbaa45a9b92", "parentComponentId": null }, { "bbox": null, "kind": "callout", "text": "The OPO executive alleged that the CEO’s sister Amira Hassanein, who runs the failed lung program, is as “confrontational” as other executives in badgering and coercing surgeons to accept and transplant organs they have already rejected as dangerous to their patient.", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:21+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a987-f53a4e740ca8", "parentComponentId": null }, { "bbox": { "h": 0.45, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "paragraph", "text": "The OPO executive alleged that the CEO's sister Amira Hassanein, who runs the failed lung program, is as \"confrontational\" as other executives in badgering and coercing surgeons to accept and transplant organs they have already rejected as dangerous to their patient: \"Waleed's sister is in charge of the lung program...we had some lungs...where the accepting center declined...the bronch was not good...the lungs were contused...these calls are 100% happening...I saw her on the line with a transplant surgeon...insisting that these lungs would have a good outcome...I was thinking, 'How do you even know that?'...well beyond her scope to insist, badger a surgeon who made a decision that transplanting this organ could put her patient in jeopardy and to sit here for 15 minutes working to actively convince them to make a different clinical decision...I've never seen anything like that...confrontational, speaking over people...speaking as if she's their boss, their attending surgeon, insisting that the organ will have a good outcome...'you don't understand the machine, you don't understand the machine....\"", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:25:56.108+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "0fec4d94-f74a-46b4-b383-29a8a468db38", "parentComponentId": null }, { "bbox": { "h": 0.32, "w": 0.86, "x": 0.07, "y": 0.62 }, "kind": "paragraph", "text": "Q: \"One surgeon told me that there are organs sometimes that he doesn't want to take, and he then gets badgered by Magdy Attia pressuring him to take them. Have you seen them try to force people to take marginal organs?\"\nA: \"Waleed's sister is in charge of the lung program....she is the one that I have witnessed do this. We had some lungs in that situation where the accepting center declined; the bronch was not good. The lungs were contused when they were recovered and I was able to witness some of those conversations myself....these calls are 100% happening...I saw her on the line with a transplant surgeon who's trying to weigh the clinical outcome for her recipient. And Amina would be on the line with her, just insisting that these lungs would have a good outcome after they were transplanted. I was thinking, 'How do you even know that?' This is confusing. I'm also not a surgeon, but it just seemed well beyond her scope to insist, badger a surgeon who made a decision that transplanting this organ could put her patient in jeopardy and to sit here for 15 minutes working to actively convince them to make a different clinical decision, I've never seen anything like that...confrontational, speaking over people, really speaking as if she's their boss, their attending surgeon, insisting that organ will have a good outcome and they're jeopardizing the patient's safety if they don't transplant it, and it's all because \"you don't understand the machine. You don't understand the machine.\" - Executive at a leading OPO, longtime industry veteran", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:25:56.108+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "476c4fba-5a24-41dd-9c88-395d876ba330", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "“Waleed’s sister is in charge of the lung program....she is the one that I have witnessed do this. We had some lungs in that situation where the accepting center declined; the bronch was not good. The lungs were contused when they were recovered and I was able to witness some of those conversations myself....these calls are 100% happening...I saw her on the line with a transplant surgeon who’s trying to weigh the clinical outcome for her recipient. And Amina would be on the line with her, just insisting that these lungs would have a good outcome after they were transplanted. I was thinking, ‘How do you even know that?’ This is confusing. I’m also not a surgeon, but it just seemed well beyond her scope to insist, badger a surgeon who made a decision that transplanting this organ could put her patient in jeopardy and to sit here for 15 minutes working to actively convince them to make a different clinical decision, I’ve never seen anything like that...confrontational, speaking over people, really speaking as if she’s their boss, their attending surgeon, insisting that organ will have a good outcome and that they’re jeopardizing the patient’s safety if they don’t transplant it, and it’s all because ‘you don’t understand the machine. You don’t understand the machine.’” — Executive at a leading OPO, longtime industry veteran", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:21+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a987-f8e6c9e277bd", "parentComponentId": null }, { "bbox": { "h": 0.02, "w": 0.3, "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:25:56.108+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "ffa996c0-e321-400b-858f-05b3356a7ff3", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [], "arcBeats": [], "loops": [], "locked": true }, { "page": 269, "type": "tension", "title": "This appears to be a narrative slide from a research note or report, focusing on churn.", "function": "diagnose_problem", "rawType": "problem_statement", "block": null, "metadata": { "slideType": "problem_statement", "slideTypeCanon": { "name": "Problem statement", "slug": "problem_statement", "status": "active", "canonId": "019de52d-0879-768d-bba8-8da8a5a121d4", "version": 1, "description": null }, "function": "diagnose_problem", "functionCanon": { "name": "Diagnose problem", "slug": "diagnose_problem", "status": "active", "canonId": "019de52d-176d-761f-b608-cf52262d2ab2", "version": 1, "description": null }, "density": "sparse", "densityScore": 11, "componentCount": 3, "textChars": 415, "nDataPoints": 0, "notes": "This appears to be a narrative slide from a research note or report, focusing on churn.", "elementsJson": [ "paragraph" ], "confidence": 0.9, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 21:25:55.566+00", "seconds": 3.663, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/269", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-269", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "Large, pre-eminent transplant centers have eliminated or sharply reduced usage; its remaining high-volume customers indicate they are in the process of doing so.", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:20+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a987-24db2c71efb1", "parentComponentId": null }, { "bbox": { "h": 0.1, "w": 0.85, "x": 0.07, "y": 0.12 }, "kind": "paragraph", "text": "Large, pre-eminent transplant centers have eliminated or sharply reduced usage; its remaining high-volume customers indicate they are in the process of doing so.", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:25:55.566+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "2ba623a0-1683-4ec2-b1b8-cd3dba3a608c", "parentComponentId": null }, { "bbox": { "h": 0.15, "w": 0.85, "x": 0.07, "y": 0.07 }, "kind": "title", "text": "Part 11. An accelerating customer exodus, the fastest such stampede we have ever encountered.", "attrs": null, "canon": { "kind": { "name": "Title", "slug": "title", "status": "active", "canonId": "019de52c-f7dd-76d9-b848-b1f12bd85cf4", "version": 1, "description": "Slide title or headline." }, "tool": null, "subkind": { "name": "Headline", "slug": "headline", "status": "active", "canonId": "019de52c-fae1-7463-9a7c-d60668eced0d", "version": 1, "description": null }, "framework": null }, "subkind": "headline", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:25:55.566+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "627a8a0c-3a2c-4fed-86f1-024544f07ac2", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [], "arcBeats": [], "loops": [], "locked": true }, { "page": 270, "type": "tension", "title": "The slide uses anecdotal evidence from a 'prominent surgeon' to support a bearish thesis on TransMedics.", "function": "name_villain", "rawType": "villain_critique", "block": null, "metadata": { "slideType": "villain_critique", "slideTypeCanon": { "name": "Villain critique", "slug": "villain_critique", "status": "active", "canonId": "019de52d-10bc-7136-bf20-09de59d17447", "version": 1, "description": null }, "function": "name_villain", "functionCanon": { "name": "Name villain", "slug": "name_villain", "status": "active", "canonId": "019de52d-1746-70d6-bc58-5eeaf5865526", "version": 1, "description": null }, "density": "dense", "densityScore": 65, "componentCount": 7, "textChars": 2267, "nDataPoints": 3, "notes": "The slide uses anecdotal evidence from a 'prominent surgeon' to support a bearish thesis on TransMedics.", "elementsJson": [ "paragraph", "quote_block", "footnote" ], "confidence": 0.95, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 21:25:55.043+00", "seconds": 2.959, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/270", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-270", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "Our research indicates that TransMedics is in the middle of an accelerating customer exodus.", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:20+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a987-a00a804ec6ee", "parentComponentId": null }, { "bbox": null, "kind": "metric", "text": "contribution margin: 60%", "attrs": null, "canon": { "kind": { "name": "Metric", "slug": "metric", "status": "active", "canonId": "019de52c-f923-73bf-8081-d0b1a8c5264d", "version": 1, "description": "Big-number or KPI value." }, "tool": { "name": "Quantification", "slug": "quantification", "status": "active", "bestFor": null, "canonId": "019dd9e1-47ab-72ce-a079-aab1f5299e88", "version": 1, "bodyDocId": null, "description": "Translating a claim into numbers, charts, or tables.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": "primary", "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:20+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a987-a803f53a27e7", "parentComponentId": null }, { "bbox": { "h": 0.45, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "paragraph", "text": "Our research indicates that TransMedics is in the middle of an accelerating customer exodus. One transplant center after another indicated that 1) using TransMedics wipes out their margin on transplant cases; 2) that despite the company’s claims to the contrary, Medicare provides only partial reimbursement to centers and that private payors offer none, forcing centers to eat the cost; 3) that alternatives are radically cheaper, whether NRP which is perhaps a mere 3 to 5% of the cost of an OCS case, or a tsunami of new entrants with cheaper, alternative perfusion/storage devices; and 4) that they plan to imminently sharply reduce or entirely eliminate their usage – within the next few months or quarters – or have already done so. We begin with a surgeon who highlighted a recent Duke University study that showed their contribution margin dropped by an astounding 60% per transplant case when they used TransMedics. The surgeon indicated “Waleed and his people got so angry at the Duke guy for bringing it up” and that Duke had to sharply reduce their usage “because they were taking such a bath.”", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:25:55.043+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "8d26db83-2569-4681-966a-a630b4d3c635", "parentComponentId": null }, { "bbox": { "h": 0.2, "w": 0.86, "x": 0.07, "y": 0.75 }, "kind": "quote", "text": "TransMedics angry at cost analysis; Duke had to reduce device usage. “Waleed and his people got so angry at the Duke guy for bringing it up... they dropped their volume by 20% because they were taking such a bath.” – Prominent surgeon", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:25:55.043+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "0955c38f-351a-4164-b263-d61a74571c76", "parentComponentId": null }, { "bbox": { "h": 0.18, "w": 0.86, "x": 0.07, "y": 0.55 }, "kind": "quote", "text": "Duke study showed 60% reduction in contribution margin per case when using TransMedics. “I talked to the Duke guys... The contribution margin was something in the 40-cent range for the cases you use TransMedics on.” – Prominent surgeon", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:25:55.043+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "e7f28628-9ffe-40ca-8e97-e2dabdd37eb8", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "\"The contribution margin was something in the 40-cent range for the cases you use TransMedics on.\" — Prominent surgeon, Director of leading academic transplant center; \"Waleed and his people got so angry at the Duke guy for bringing it up. I know for a fact that the Duke guys were on target to do a huge percentage of their liver transplants using TransMedics in a given year but they dropped their volume by 20% because they were taking such a bath.\" — Prominent surgeon, Director of leading academic transplant center", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:20+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a987-a7a979082c9e", "parentComponentId": null }, { "bbox": { "h": 0.02, "w": 0.25, "x": 0.07, "y": 0.96 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:25:55.043+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "24066258-755b-40f3-b56d-d9c44b85bc40", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [], "arcBeats": [], "loops": [], "locked": true }, { "page": 271, "type": "tension", "title": "The slide uses direct quotes from surgeons to build a narrative of financial unviability and institutional pushback against the product.", "function": "name_villain", "rawType": "villain_critique", "block": null, "metadata": { "slideType": "villain_critique", "slideTypeCanon": { "name": "Villain critique", "slug": "villain_critique", "status": "active", "canonId": "019de52d-10bc-7136-bf20-09de59d17447", "version": 1, "description": null }, "function": "name_villain", "functionCanon": { "name": "Name villain", "slug": "name_villain", "status": "active", "canonId": "019de52d-1746-70d6-bc58-5eeaf5865526", "version": 1, "description": null }, "density": "dense", "densityScore": 70, "componentCount": 8, "textChars": 1670, "nDataPoints": 4, "notes": "The slide uses direct quotes from surgeons to build a narrative of financial unviability and institutional pushback against the product.", "elementsJson": [ "paragraph", "quote_block" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 21:25:55.467+00", "seconds": 3.158, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/271", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-271", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "One stated his margin per case drops by more than 90%, from $100-120K to $10K with the device; the other stated “you are eating up a very, very substantial amount of the margin, no doubt about it.”", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:21+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a988-2556a2c06110", "parentComponentId": null }, { "bbox": null, "kind": "metric", "text": "margin per case: 90%", "attrs": null, "canon": { "kind": { "name": "Metric", "slug": "metric", "status": "active", "canonId": "019de52c-f923-73bf-8081-d0b1a8c5264d", "version": 1, "description": "Big-number or KPI value." }, "tool": { "name": "Quantification", "slug": "quantification", "status": "active", "bestFor": null, "canonId": "019dd9e1-47ab-72ce-a079-aab1f5299e88", "version": 1, "bodyDocId": null, "description": "Translating a claim into numbers, charts, or tables.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": "primary", "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:21+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a988-2c02cec55c79", "parentComponentId": null }, { "bbox": { "h": 0.15, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "paragraph", "text": "The surgeon stated that TransMedics largest users are beginning to curtail usage – we heard from others that Duke and Massachusetts General were ~100% of the usage during the trial, and that both are moving on.", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:25:55.467+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "8c991fc7-2b7c-47b3-a326-57ecae5f9498", "parentComponentId": null }, { "bbox": { "h": 0.18, "w": 0.86, "x": 0.07, "y": 0.68 }, "kind": "quote", "text": "Margin drops 90% or more if using TransMedics... my margin on the case is $10,000 because I still have to pay for using the TransMedics device out of that global contract.", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:25:55.467+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "1b4293ca-bef5-439d-9143-56a56f884cfe", "parentComponentId": null }, { "bbox": { "h": 0.15, "w": 0.86, "x": 0.07, "y": 0.51 }, "kind": "quote", "text": "Duke analysis was the talk of the conference... I heard Waleed’s head almost exploded. And they said, yeah, they don’t like us very much anymore.", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:25:55.467+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "90295db7-73c9-4907-be97-f3a195639181", "parentComponentId": null }, { "bbox": { "h": 0.08, "w": 0.86, "x": 0.07, "y": 0.87 }, "kind": "quote", "text": "Eats up “very substantial amount of the margin”... you are eating up a very, very substantial amount of the margin, no doubt about it.", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:25:55.467+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "c6bccf29-a633-4e26-bcf3-d5bfb8fa4a09", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "“I heard Waleed’s head almost exploded” — Prominent surgeon, Director of leading academic transplant center. “Whether I use TransMedics or whether I put it in a cooler of ice, I still get $300,000. But when I put it in the cooler of ice and bring the organ, my margin on the case is, let’s say, $100,000-120,000 or something. When I do it, and I then use the OCS device, my margin on the case is $10,000” — Transplant surgeon and transplant program director at a leading Northeast academic center. “All of this is very true and it very much eats up your margin...you are eating up a very, very substantial amount of the margin, no doubt about it.” — Transplant hepatologist and director of the liver program at a Midwest academic center.", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:21+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a988-28b8bd72d228", "parentComponentId": null }, { "bbox": { "h": 0.02, "w": 0.25, "x": 0.07, "y": 0.96 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:25:55.467+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "469a8ae1-3d63-4ef1-b0fa-1ebbcc1d0bc2", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [], "arcBeats": [], "loops": [], "locked": true }, { "page": 272, "type": "tension", "title": "The slide uses a Q&A format to directly contradict claims made by the TransMedics CEO regarding reimbursement pass-through.", "function": "expose_contradiction", "rawType": "testimonial", "block": null, "metadata": { "slideType": "testimonial", "slideTypeCanon": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52d-0a2d-7782-8a48-7e84df92cc97", "version": 1, "description": null }, "function": "expose_contradiction", "functionCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-171f-776f-887c-73edaff4cf9c", "version": 1, "description": null }, "density": "dense", "densityScore": 58, "componentCount": 7, "textChars": 1363, "nDataPoints": 4, "notes": "The slide uses a Q&A format to directly contradict claims made by the TransMedics CEO regarding reimbursement pass-through.", "elementsJson": [ "paragraph", "quote_block" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 21:25:59.272+00", "seconds": 6.952, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/272", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-272", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "Because of the cost, people are going to start shifting gears, and they're going to be changing to a different pump because it's not sustainable for a transplant center.", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:20+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a987-8ca0ca4c70ea", "parentComponentId": null }, { "bbox": { "h": 0.25, "w": 0.9, "x": 0.05, "y": 0.65 }, "kind": "list", "text": "Q&A transcript detailing the $170k vs $90k-$100k profit margin impact and the lack of private insurance reimbursement.", "attrs": null, "canon": { "kind": { "name": "List", "slug": "list", "status": "active", "canonId": "019de52c-f94b-779b-a53b-fd4904a5f4d2", "version": 1, "description": "Bullet or numbered list." }, "tool": null, "subkind": { "name": "Bullet list", "slug": "bullet", "status": "active", "canonId": "019de52c-fc98-7169-a083-5cab805076ca", "version": 1, "description": null }, "framework": null }, "subkind": "bullet", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:25:59.272+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "5f6f4709-1b90-483d-a8d3-8fab69f674e8", "parentComponentId": null }, { "bbox": { "h": 0.05, "w": 0.9, "x": 0.05, "y": 0.6 }, "kind": "paragraph", "text": "Profit per case drops by half; insufficient Medicare reimbursement and almost none for commercial", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:25:59.272+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "f0bf97c5-2186-415a-86e4-d04d9da30c96", "parentComponentId": null }, { "bbox": { "h": 0.2, "w": 0.9, "x": 0.05, "y": 0.35 }, "kind": "quote", "text": "Because of the cost, people are going to start shifting gears, and they're going to be changing to a different pump because it's not sustainable for a transplant center...", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:25:59.272+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "be374547-732a-4625-949f-25108e3b7989", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "“Because of the cost, people are going to start shifting gears, and they're going to be changing to a different pump because it's not sustainable for a transplant center, and I understand that TransMedics, they're going to tell you, this is going to be covered by Medicare and by private insurance and yadda, yadda. The reality is that this is going to drive the healthcare cost - you already know that the healthcare in America is destroyed - so this is going to kill the healthcare system.” — Transplant surgeon at Vanderbilt", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:20+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a987-9306488262b3", "parentComponentId": null }, { "bbox": { "h": 0.03, "w": 0.3, "x": 0.05, "y": 0.95 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:25:59.272+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "b533853c-9797-4bef-a8c1-cfa553b39831", "parentComponentId": null }, { "bbox": { "h": 0.15, "w": 0.9, "x": 0.05, "y": 0.05 }, "kind": "title", "text": "A transplant surgeon at Vanderbilt, who plays a leadership role at their liver center - one of the busiest in the world - did a deep dive to explain reimbursement dynamics and why TransMedics nukes his margin by half per case", "attrs": null, "canon": { "kind": { "name": "Title", "slug": "title", "status": "active", "canonId": "019de52c-f7dd-76d9-b848-b1f12bd85cf4", "version": 1, "description": "Slide title or headline." }, "tool": null, "subkind": { "name": "Headline", "slug": "headline", "status": "active", "canonId": "019de52c-fae1-7463-9a7c-d60668eced0d", "version": 1, "description": null }, "framework": null }, "subkind": "headline", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:25:59.272+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "34ccf0af-ff3c-4b44-bf39-8d21d26dc232", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [ { "matchId": "d778355c-c77e-4a9c-a8a6-07cd4a68a365", "evidence": "The slide explicitly contrasts the surgeon's experience with the CEO's claims.", "framework": null, "confidence": 0.95, "extraction": { "at": "2026-05-02 21:25:59.272+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 272, "frameworkName": "ceo-quote-contradiction" } ], "arcBeats": [], "loops": [], "locked": true }, { "page": 273, "type": "tension", "title": "The slide uses direct quotes to build a narrative of customer churn and institutional resistance.", "function": "name_villain", "rawType": "villain_critique", "block": null, "metadata": { "slideType": "villain_critique", "slideTypeCanon": { "name": "Villain critique", "slug": "villain_critique", "status": "active", "canonId": "019de52d-10bc-7136-bf20-09de59d17447", "version": 1, "description": null }, "function": "name_villain", "functionCanon": { "name": "Name villain", "slug": "name_villain", "status": "active", "canonId": "019de52d-1746-70d6-bc58-5eeaf5865526", "version": 1, "description": null }, "density": "dense", "densityScore": 64, "componentCount": 7, "textChars": 3483, "nDataPoints": 0, "notes": "The slide uses direct quotes to build a narrative of customer churn and institutional resistance.", "elementsJson": [ "paragraph", "quote_block" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 21:26:00.395+00", "seconds": 8.066, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/273", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-273", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "The Vanderbilt surgeon’s sharp comments are representative of the tsunami of anger and new entrants causing TransMedics customers to flee.", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:21+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a987-ceb4c764f1f7", "parentComponentId": null }, { "bbox": { "h": 0.35, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "paragraph", "text": "The Vanderbilt surgeon’s sharp comments are representative of the tsunami of anger and new entrants causing TransMedics customers to flee. He stated his colleagues on the heart side loathe TransMedics, which we confirmed by interviewing a transplant cardiologist there: “Vanderbilt is the biggest heart transplant program not in the country but in the world. The volume is gigantic. They do zero TransMedics...they are so upset...they hate the company.” A surgeon and head of the program at a major Pennsylvania academic center echoed the comments, stating his hospital has cracked down and rationed usage, and that he would get fired if he uses the device too much: “we started using TransMedics a year ago...we had to talk about using it a reasonable amount because of the cost...the price of the plane, I mean...let’s be honest...the question you have to ask yourself is hard...I know I can’t use it too much, or I’m not going to be making any money, and then I’m not going to have a job.”", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:26:00.395+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "889d2ef4-5f7a-460f-8555-77e4a6abdd77", "parentComponentId": null }, { "bbox": { "h": 0.15, "w": 0.86, "x": 0.07, "y": 0.45 }, "kind": "quote", "text": "Vanderbilt heart program refuses to use TransMedics. “Vanderbilt is the biggest heart transplant program not in the country but in the world. The volume is gigantic. They do zero TransMedics. Zero because they are so upset. They were extremely upset. So, they don’t use TransMedics at all. They hate it. They hate the company. They hate is so much. They really hate it.” -Transplant surgeon at Vanderbilt", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:26:00.395+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "7c5beba6-59ae-44ad-9081-15f6d2d05c24", "parentComponentId": null }, { "bbox": { "h": 0.12, "w": 0.86, "x": 0.07, "y": 0.83 }, "kind": "quote", "text": "Surgeon stated he’ll get fired if using the device too much. “I know I can’t use it too much, or I’m not going to be making any money, and then I’m not going to have a job...if a hospital thinks they’re losing money by providing a service, are they really going to go out and provide a service? So, that’s why I said I had to have an actual financial talk with my head of finance and describe the margins and how they’re doing.” - Transplant surgeon and transplant program director at a major academic center in Pennsylvania", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:26:00.395+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "9aa4b3c9-dba2-4648-88e3-18f230f7a6d0", "parentComponentId": null }, { "bbox": { "h": 0.2, "w": 0.86, "x": 0.07, "y": 0.62 }, "kind": "quote", "text": "Had to ration usage because of the cost. “We do about mid-80s to mid-90s, so just under 100 liver transplants a year...we started using TransMedics about a year ago...We had to talk about using it at a reasonable volume because of the cost and we have a budgeted percentage of transplants we’re allowed to use it in...Yeah, their technician has to put it on the pump and has to run the pump. They keep the pump, and they run the pump...The price of the plane, I mean...let’s be honest. And then the cost of the disposables and the charge, it’s a lot. The question you have to ask is hard.” - Transplant surgeon and transplant program director at a major academic center in Pennsylvania", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:26:00.395+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "ffb12ac6-0c56-4fce-bb00-842f667f14da", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "\"Vanderbilt is the biggest heart transplant program not in the country but in the world. The volume is gigantic. They do zero TransMedics...they are so upset...they hate the company.\" — Transplant surgeon at Vanderbilt. \"I know I can’t use it too much, or I’m not going to be making any money, and then I’m not going to have a job...if a hospital thinks they’re losing money by providing a service, are they really going to go out and provide a service? So, that’s why I said I had to have an actual financial talk with my head of finance and describe the margins and how they’re doing.\" — Transplant surgeon and transplant program director at a major academic center in Pennsylvania.", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:21+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a987-d341b81d5214", "parentComponentId": null }, { "bbox": { "h": 0.02, "w": 0.25, "x": 0.07, "y": 0.96 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:26:00.395+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "77894f8e-137c-456c-839e-15da1b0f5148", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [], "arcBeats": [], "loops": [], "locked": true }, { "page": 274, "type": "tension", "title": "The slide uses Q&A transcripts to highlight a shift away from OCS technology in high-volume transplant centers.", "function": "expose_contradiction", "rawType": "expose_contradiction", "block": null, "metadata": { "slideType": "expose_contradiction", "slideTypeCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-124c-75aa-984a-0a3d0d8fc8df", "version": 1, "description": null }, "function": "expose_contradiction", "functionCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-171f-776f-887c-73edaff4cf9c", "version": 1, "description": null }, "density": "overcrowded", "densityScore": 79, "componentCount": 8, "textChars": 3686, "nDataPoints": 6, "notes": "The slide uses Q&A transcripts to highlight a shift away from OCS technology in high-volume transplant centers.", "elementsJson": [ "paragraph", "quote_block", "footnote" ], "confidence": 0.95, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 21:25:56.763+00", "seconds": 4.311, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/274", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-274", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "He stated their OCS usage fell from 60-70 cases from 2020 to 2023 to four cases in 2024, and that he sees the same trend at leading heart transplant programs around the country.", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:21+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a988-81fe88cd6657", "parentComponentId": null }, { "bbox": { "h": 0.02, "w": 0.65, "x": 0.07, "y": 0.62 }, "kind": "list", "text": "Vanderbilt has ceased usage; high-volume users like UCSF are next with competition from NRP and coolers", "attrs": null, "canon": { "kind": { "name": "List", "slug": "list", "status": "active", "canonId": "019de52c-f94b-779b-a53b-fd4904a5f4d2", "version": 1, "description": "Bullet or numbered list." }, "tool": null, "subkind": { "name": "Bullet list", "slug": "bullet", "status": "active", "canonId": "019de52c-fc98-7169-a083-5cab805076ca", "version": 1, "description": null }, "framework": null }, "subkind": "bullet", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:25:56.763+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "1bb1295a-ec68-42fc-aee6-58e972d217e2", "parentComponentId": null }, { "bbox": { "h": 0.02, "w": 0.35, "x": 0.07, "y": 0.33 }, "kind": "list", "text": "Vanderbilt heart usage of OCS has tanked", "attrs": null, "canon": { "kind": { "name": "List", "slug": "list", "status": "active", "canonId": "019de52c-f94b-779b-a53b-fd4904a5f4d2", "version": 1, "description": "Bullet or numbered list." }, "tool": null, "subkind": { "name": "Bullet list", "slug": "bullet", "status": "active", "canonId": "019de52c-fc98-7169-a083-5cab805076ca", "version": 1, "description": null }, "framework": null }, "subkind": "bullet", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:25:56.763+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "73abefff-332a-464c-825f-7cd1da6383db", "parentComponentId": null }, { "bbox": { "h": 0.25, "w": 0.86, "x": 0.07, "y": 0.36 }, "kind": "paragraph", "text": "A: “Over the last four-ish years or so, we’ve done about 125 heart or multi-organ transplants, including heart per year. We’re shooting to around 140, I’m told, by the end of 2024. We perform the most heart transplants globally. Roughly, because I have the numbers in hand, between January 2020 and January 2023, and this is publicly available from data we’ve published [...] the use of OCS was roughly about a third of those hearts. 21 out of 122—that’s like 1/6 of the DCD hearts during that three-year time frame used OCS. Out of 120 cases and that was just for DCD. We used it probably another 30 or 40 times amongst another 260 brain-dead hearts during that same time frame. So, probably brings our total OCS volume between 2020 and 2023 to roughly about 60-70 or so.” Q: “How is that trending?” A: “The trend has been going down. For example, thus far this year, we’ve used it four times. Last year, OCS overall for the entirety of January to December 2023, we used it a total of 12 times over all DCD cases.”-Transplant cardiologist at Vanderbilt", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:25:56.763+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "8100b9bf-177a-4133-a85a-66572d72b872", "parentComponentId": null }, { "bbox": { "h": 0.25, "w": 0.86, "x": 0.07, "y": 0.65 }, "kind": "paragraph", "text": "Q: “Are there programs that you know of where the utilization of OCS has just really gone down dramatically? They stopped using it completely, like high-volume ones?” A: “That was essentially us. Three years ago, I thought we were going to be using it a lot more and it dropped down into the low single digits in this time span. The more we talked to other high volume centers like UCSF, etc., there’s just lots and lots of utilization of it. We’ve all gotten good at NRP. We all have large surgical teams to send our surgeons and perfusionists to procure organs via NRP, and we’re involved in all these different cooler trials regardless of what cooler it may be, and we’re getting the same distance benefits from those coolers as well. But it really cuts down the need for OCS in terms of what situations are we really using it for. We’re not using them for marginal hearts anymore, really. We’re not really using them for distance. It really comes down to what are those few scenarios per year where we generally don’t have the surgical bandwidth when we have a potential offer for one of our listed patients.” -Transplant cardiologist at Vanderbilt", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:25:56.763+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "be63e678-25fb-4dd5-b33f-dfd1cb08d5de", "parentComponentId": null }, { "bbox": { "h": 0.25, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "paragraph", "text": "A second Vanderbilt source – a transplant cardiologist – echoed the color from his liver transplant colleague for heart/lung, stating that they are the highest volume transplant program in the world. He stated their OCS usage fell from 60-70 cases from 2020 to 2023 to four cases in 2024, and that he sees the same trend at leading heart transplant programs around the country, due to the superiority of NRP and the fact that newer coolers provide the same benefits at a fraction of the cost: “the trend has been going down...three years ago I thought we were going to be using it a lot more and it dropped into the low single digits in this timespan...we’re involved in all these different cooler trials...and we’re getting the same distance benefits from those coolers as well.”", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:25:56.763+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "cf708d13-5dc5-4c1a-953b-0d9800a23eba", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "the trend has been going down...three years ago I thought we were going to be using it a lot more and it dropped into the low single digits in this timespan...we're involved in all these different cooler trials...and we're getting the same distance benefits from those coolers as well. — Transplant cardiologist at Vanderbilt", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:21+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a988-85008653c6ee", "parentComponentId": null }, { "bbox": { "h": 0.02, "w": 0.3, "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:25:56.763+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "8d1b4213-10c8-43ae-b423-564d99281b47", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [], "arcBeats": [], "loops": [], "locked": true }, { "page": 275, "type": "tension", "title": "The slide uses a 'villain critique' style to highlight negative sentiment from industry insiders regarding TransMedics.", "function": "expose_contradiction", "rawType": "expose_contradiction", "block": null, "metadata": { "slideType": "expose_contradiction", "slideTypeCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-124c-75aa-984a-0a3d0d8fc8df", "version": 1, "description": null }, "function": "expose_contradiction", "functionCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-171f-776f-887c-73edaff4cf9c", "version": 1, "description": null }, "density": "overcrowded", "densityScore": 75, "componentCount": 9, "textChars": 2062, "nDataPoints": 0, "notes": "The slide uses a 'villain critique' style to highlight negative sentiment from industry insiders regarding TransMedics.", "elementsJson": [ "paragraph", "quote_block", "footnote" ], "confidence": 0.95, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 21:25:56.95+00", "seconds": 4.041, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/275", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-275", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "The list of major transplant centers which have reduced, eliminated, or are on a path to terminate TransMedics usage is long and growing quickly.", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:21+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a988-3c7d7ea84179", "parentComponentId": null }, { "bbox": { "h": 0.08, "w": 0.86, "x": 0.07, "y": 0.27 }, "kind": "paragraph", "text": "MGH played a key role in the pivotal PROTECT trial, but two sources - a transplant physician and a hospital executive, both in leadership roles – expressed growing dismay and alarm, respectively, at the company’s practices.", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:25:56.95+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "6f273e09-8df7-49e9-9375-1a142b11c2ed", "parentComponentId": null }, { "bbox": { "h": 0.08, "w": 0.86, "x": 0.07, "y": 0.19 }, "kind": "paragraph", "text": "We document others beyond the ones already quoted, with the following on this page alone: Massachusetts General, University of Cincinnati, University of Virginia, and University of Washington.", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:25:56.95+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "c527cb10-92a7-4917-8eb0-9aeb842098ff", "parentComponentId": null }, { "bbox": { "h": 0.08, "w": 0.86, "x": 0.07, "y": 0.51 }, "kind": "quote", "text": "MGH signaled their intent to reduce usage of TransMedics. \"I am not solely loyal to TransMedics. We do use TransMedics quite a bit, and I do have thoughts regarding the future\" – Veteran transplant administrator/executive at MGH", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:25:56.95+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "a9515598-e402-4393-a167-de614d7d32c8", "parentComponentId": null }, { "bbox": { "h": 0.15, "w": 0.86, "x": 0.07, "y": 0.77 }, "kind": "quote", "text": "University of Washington allegedly trying to kill off TransMedics usage; questionable outcomes. \"...they were trying to block all TransMedics business... they were making an effort to not use it at all... they were worried about the outcomes...\"", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:25:56.95+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "d28ac727-85a3-4ab0-b627-a1bdbec05b97", "parentComponentId": null }, { "bbox": { "h": 0.15, "w": 0.86, "x": 0.07, "y": 0.61 }, "kind": "quote", "text": "Major centers moving to competing devices. \"I know University of Cincinnati was using TransMedics, and they're getting away from it... University of Virginia is another one.\" – Executive at a major OPO", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:25:56.95+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "fa67c41f-fafc-46af-a93a-8a240dea016a", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "\"I am not solely loyal to TransMedics. We do use TransMedics quite a bit, and I have thoughts regarding the future\" — Veteran transplant administrator/executive at Massachusetts General Hospital; \"I know University of Cincinnati was using TransMedics, and they're getting away from it because it's just so darn expensive... University of Virginia is another one.\" — Executive at a major OPO; \"One of my contacts works here locally at UW... they were trying to block all TransMedics business because they're upset about the cost and everything... they were making an effort to use it at all.\" — Former TransMedics OCS specialist", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:21+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a988-434f899f63fd", "parentComponentId": null }, { "bbox": { "h": 0.03, "w": 0.25, "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:25:56.95+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "da9e3220-3034-41e4-ba58-9febedae31e5", "parentComponentId": null }, { "bbox": { "h": 0.12, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "title", "text": "The list of major transplant centers which have reduced, eliminated, or are on a path to terminate TransMedics usage is long and growing quickly.", "attrs": null, "canon": { "kind": { "name": "Title", "slug": "title", "status": "active", "canonId": "019de52c-f7dd-76d9-b848-b1f12bd85cf4", "version": 1, "description": "Slide title or headline." }, "tool": null, "subkind": { "name": "Headline", "slug": "headline", "status": "active", "canonId": "019de52c-fae1-7463-9a7c-d60668eced0d", "version": 1, "description": null }, "framework": null }, "subkind": "headline", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:25:56.95+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "5064e2ca-b319-4674-8867-28dcc125e9ff", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [ { "matchId": "a3a70d21-00df-48bd-afa4-8b76b301d215", "evidence": "The slide systematically presents negative testimonials to undermine the company's market position.", "framework": null, "confidence": 0.8, "extraction": { "at": "2026-05-02 21:25:56.95+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 275, "frameworkName": "villain-critique" } ], "arcBeats": [], "loops": [], "locked": true }, { "page": 276, "type": "tension", "title": "The slide uses a Q&A format to highlight a specific expert's negative sentiment toward TransMedics.", "function": "expose_contradiction", "rawType": "testimonial", "block": null, "metadata": { "slideType": "testimonial", "slideTypeCanon": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52d-0a2d-7782-8a48-7e84df92cc97", "version": 1, "description": null }, "function": "expose_contradiction", "functionCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-171f-776f-887c-73edaff4cf9c", "version": 1, "description": null }, "density": "dense", "densityScore": 68, "componentCount": 7, "textChars": 3080, "nDataPoints": 2, "notes": "The slide uses a Q&A format to highlight a specific expert's negative sentiment toward TransMedics.", "elementsJson": [ "paragraph", "footnote" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 21:25:57.54+00", "seconds": 4.537, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/276", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-276", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "A surgeon who directs the program expects to terminate their usage in the next 6-12 months: \"Yes, it will go to zero.\"", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:21+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a988-0ce6eec6b02e", "parentComponentId": null }, { "bbox": { "h": 0.15, "w": 0.86, "x": 0.07, "y": 0.26 }, "kind": "paragraph", "text": "The surgeon is actively shopping for new, competing devices at a quarter of the cost, such LifePort or XVIVO; and noted that centers which have already made the switch now “don’t use TransMedics ever, very rarely...they use their own pump...Wash U in St. Louis, you should talk to [redacted]...they don’t use TransMedics”; “I’m very interested in their platform.” The surgeon warned that “if I were an investor, I would be very wary of investing in TransMedics...I don’t the field is going to move in their direction....we are going to get other options...there is going to be competition.”", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:25:57.54+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "1f27f7cb-fe30-4120-92c3-b071201f8985", "parentComponentId": null }, { "bbox": { "h": 0.48, "w": 0.86, "x": 0.07, "y": 0.45 }, "kind": "quote", "text": "Shopping for alternatives and TransMedics likely to “go to zero” shortly. A: “As a surgeon, I am still going to use TransMedics now. But I am definitely shopping. I’m shopping for other options.” Q: “And when do you think it’ll impact your use of TransMedics, particularly for liver?” A: “Once we get a pump here at [center redacted] that we like, we’re looking—so, XVIVO, they also have a hypothermic pump like LifePort. They are not FDA-approved in the United States. They are widely used in Europe, so they’ve been incredibly successful in Europe and I’m very interested in their platform because they have excellent outcomes on their pump and they have a back-to-base model, which would allow the transplant center to buy their pump, use their own procurement team, and pump livers at home, and it’s a lot cheaper, like $20,000 versus $80,000. I would like to buy a pump in the next year, either LifePort or XVIVO and have that option for my team so that we don’t have to use TransMedics.” Q: “Once you do that, does your volume of TransMedics go close to zero?” A: “Yes, it will go to zero.” Q: “And do you think this is a realistic possibility in the next 6-12 months?” A: “I think it is. I think the centers that have LifePort, for example, they don’t use TransMedics ever, very rarely. They use their own pump. Or Wash U in St Louis, you should talk to [surgeon name redacted]. They don’t use TransMedics; they use their own pump... if I were an investor, I would be very wary of investing in TransMedics. I don’t think the field is going to move in their direction. I think it’s still going to be judicious utilization of the pump because of the cost associated with the pump, and I think we are going to get other options. There is going to be competition.” – Chief of transplant surgery at a major transplant center; high-volume TransMedics user", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:25:57.54+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "d7c4eda8-f14f-4ffe-8597-c51b8e29a7c7", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "\"Yes, it will go to zero.\" — Chief of transplant surgery at a major transplant center; high-volume TransMedics user", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:21+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a988-1085c822e810", "parentComponentId": null }, { "bbox": { "h": 0.02, "w": 0.25, "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:25:57.54+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "1eb365b1-ac36-4cd7-9a46-22152a0b04f0", "parentComponentId": null }, { "bbox": { "h": 0.06, "w": 0.86, "x": 0.07, "y": 0.19 }, "kind": "title", "text": "A surgeon who directs the program expects to terminate their usage in the next 6-12 months: “Yes, it will go to zero.”", "attrs": null, "canon": { "kind": { "name": "Title", "slug": "title", "status": "active", "canonId": "019de52c-f7dd-76d9-b848-b1f12bd85cf4", "version": 1, "description": "Slide title or headline." }, "tool": null, "subkind": { "name": "Action title", "slug": "action-title", "status": "active", "canonId": "019de52c-fb31-734c-a0f5-a3935b73135d", "version": 1, "description": null }, "framework": null }, "subkind": "action-title", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:25:57.54+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "5c5d9977-c51d-4949-b1c2-9df3577ac63e", "parentComponentId": null }, { "bbox": { "h": 0.12, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "title", "text": "A CA-based transplant center – one of the largest in the country by volume of liver transplants and a heavy OCS user – illustrates the disillusionment with TransMedics rapidly unfolding in the transplant field in recent months.", "attrs": null, "canon": { "kind": { "name": "Title", "slug": "title", "status": "active", "canonId": "019de52c-f7dd-76d9-b848-b1f12bd85cf4", "version": 1, "description": "Slide title or headline." }, "tool": null, "subkind": { "name": "Headline", "slug": "headline", "status": "active", "canonId": "019de52c-fae1-7463-9a7c-d60668eced0d", "version": 1, "description": null }, "framework": null }, "subkind": "headline", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:25:57.54+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "e17232b2-0b5c-4eda-8320-95a697a49e96", "parentComponentId": null } ], "metrics": [], "tools": [ { "tool": { "name": "Action Titles", "slug": "action-titles", "status": "active", "bestFor": "Any decision-grade deliverable — strategy recommendation, board update, investment memo, M&A review, post-mortem — where the reader is being asked to agree, decide, or act and will skim the title bar at speed.", "canonId": "019dd956-ac70-700b-a608-ba58e78f5dcc", "version": 1, "bodyDocId": "816dad3c-9983-41c1-a86e-978ebd582841", "description": "The McKinsey-bred discipline of writing every slide title as a complete declarative sentence with a verb and an insight, not a topic label. Each title is a sub-claim that ladders up to the deck's governing thought; read in sequence, the titles reconstruct the executive summary.", "familyLabel": null, "categoryName": "Slide", "categorySlug": "slide" }, "agent": "Architect", "layer": "slide", "agents": [ "Architect" ], "matchId": "7ba82a1c-d789-4e92-9c08-acb9f74f0a31", "evidence": "The slide has an action title 'A surgeon who directs the program expects to terminate their usage in the next 6-12 months: “Yes, it will go to zero.”'", "pageRefs": null, "priority": "Core", "whenToUse": "Any decision-grade deliverable — strategy recommendation, board update, investment memo, M&A review, post-mortem — where the reader is being asked to agree, decide, or act and will skim the title bar at speed.", "confidence": 0.7, "extraction": { "at": "2026-07-16 23:10:53.310228+00", "model": "or:meta-llama/llama-4-scout", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 276, "whyItWorks": "Solves two failure modes at once. (1) The buried claim: action titles place the conclusion on the page before any analysis is read, so a busy reader doesn't reverse-engineer it from the chart. (2) The spineless deck: because each title is a claim, slides have to ladder up to the governing thought; logical gaps become visible as topic-shaped titles in a sequence that no longer reads as a story.", "antipattern": "Topic labels disguised as titles — Volume by quarter, Key findings, Pricing strategy, Margins have been impacted. No verb, or a passive verb with no agent, or a fact (Revenue grew 12%) without the so-what. Also: titles that overreach the chart's evidence, multi-claim X-grew-but-Y-fell welded titles, and mechanical repetition of the same X-drove-Y template across the deck.", "cardinality": null, "narrativePurpose": "Forces the deck to carry its argument in the title bar so a senior reader can extract the recommendation without opening a single slide; converts a binder of topics into a navigable pyramid where every slide is a node defending the apex." } ], "frameworks": [], "arcBeats": [], "loops": [], "locked": true }, { "page": 277, "type": "tension", "title": "The slide uses direct quotes from a high-volume TransMedics user to illustrate market vulnerability and the shift toward competitors offering more autonomy.", "function": "expose_contradiction", "rawType": "quote_slide", "block": null, "metadata": { "slideType": "quote_slide", "slideTypeCanon": { "name": "Quote slide", "slug": "quote_slide", "status": "active", "canonId": "019de52d-098e-7555-a9fd-4f0af7e80bc2", "version": 1, "description": null }, "function": "expose_contradiction", "functionCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-171f-776f-887c-73edaff4cf9c", "version": 1, "description": null }, "density": "dense", "densityScore": 56, "componentCount": 6, "textChars": 3454, "nDataPoints": 0, "notes": "The slide uses direct quotes from a high-volume TransMedics user to illustrate market vulnerability and the shift toward competitors offering more autonomy.", "elementsJson": [ "paragraph", "quote_block" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 21:25:57.189+00", "seconds": 4.081, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/277", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-277", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "I don't see any advantage in using their pump anymore.", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:21+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a987-e368afcc448c", "parentComponentId": null }, { "bbox": { "h": 0.38, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "paragraph", "text": "The surgeon laid out a competitive and regulatory avalanche, such as a cap on the device cost: “competitors are coming down the pipe pretty quickly...they’re not going to have the monopoly anymore....there’s going to be regulatory change...we really can’t justify the cost...there’s going to have to be some kind of cap...again, as a consumer, I am shopping.” The surgeon noted irksome calls and pressure from TransMedics to use the device even when not clinically indicated – “I don’t see any advantage in using their pump anymore” – and chafed at the lack of control after being forced to use and pay up for TransMedics device technicians and procurement, versus newer entrants that give the surgeon full control and autonomy: “then we can control the procurement...what goes on the pump, and we can decide...the field is going to move towards companies that are willing to sell their pump to the actual transplant center.”", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:25:57.189+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "e5d22c0d-9ca3-4f7f-b9e0-c91186172023", "parentComponentId": null }, { "bbox": { "h": 0.25, "w": 0.86, "x": 0.07, "y": 0.48 }, "kind": "quote", "text": "No advantage in using the pump\n“I think the biggest risks are that, one, there are competitors coming down the pipe pretty quickly. So, they’re not going to have the monopoly anymore. I think that there’s going to be regulatory change. I think pretty soon the US government is going to or insurance companies are going to say yes, you guys are increasing the total number of transplants for this country but we really can’t justify the cost. So, there’s going to have to be some kind of cap or something. I think that it could be that some of these negative stories also make the company more vulnerable...again, as a consumer, I am shopping...they will reach out to us and they’ll say, we notice that you haven’t been using our pump a lot recently. What’s going on? I do find it off-putting. Like, I will use your pump when I decide to use your pump. I don’t see any advantage in using their pump anymore. They want us to use their pump as much as possible. They’ll call and say, we noticed there was a drop-off. You had a great January, February - and now you’re not really using our pump in March. What’s going on?” – Chief of transplant surgery at a major transplant center; high-volume TransMedics user", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:25:57.189+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "2d85da8f-adf6-44e6-83ac-bb25bbc31862", "parentComponentId": null }, { "bbox": { "h": 0.18, "w": 0.86, "x": 0.07, "y": 0.75 }, "kind": "quote", "text": "Competitors coming online; allow centers to control the device; field moving in that direction\n“The FDA just approved LifePort, which is a hypothermic pump. Sometime this year, and it’s been around a lot longer than TransMedics. But they have been around a lot longer than TransMedics. But they have been really slow at getting their FDA approval. So, now they’re ready to roll and sell LifePort...we are interested in purchasing LifePort. Another company is called XVIVO, another hypothermic platform. And the benefit of those pumps is that you can sell the actual pump to a transplant center, and then we can control the procurement, and we can control what goes on pump, and we can decide. So, I think that the field is going to move towards companies that are willing to sell their pump to the actual transplant center.” – Chief of transplant surgery at a major transplant center; high-volume TransMedics user", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:25:57.189+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "e31ad82b-3d47-43e9-9eea-12713eb7c80d", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "\"I think the biggest risks are that, one, there are competitors coming down the pipe pretty quickly. So, they're not going to have the monopoly anymore... I don't see any advantage in using their pump anymore.\" — Chief of transplant surgery at a major transplant center; high-volume TransMedics user", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:21+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a987-e45c8e852ad8", "parentComponentId": null }, { "bbox": { "h": 0.02, "w": 0.25, "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:25:57.189+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "7d2e0fbc-84a1-4fd3-bd42-8e29486aa6af", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [], "arcBeats": [], "loops": [], "locked": true }, { "page": 278, "type": "tension", "title": "The slide uses a Q&A format to build a narrative of market abandonment.", "function": "expose_contradiction", "rawType": "testimonial", "block": null, "metadata": { "slideType": "testimonial", "slideTypeCanon": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52d-0a2d-7782-8a48-7e84df92cc97", "version": 1, "description": null }, "function": "expose_contradiction", "functionCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-171f-776f-887c-73edaff4cf9c", "version": 1, "description": null }, "density": "dense", "densityScore": 50, "componentCount": 6, "textChars": 1893, "nDataPoints": 0, "notes": "The slide uses a Q&A format to build a narrative of market abandonment.", "elementsJson": [ "paragraph", "quote_block", "footnote" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 21:25:55.963+00", "seconds": 2.824, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/278", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-278", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "there's going to be no real utility in using OCS in comparison to other cheaper, more widely-available...it's a no-brainer.", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:21+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a988-68d538cba910", "parentComponentId": null }, { "bbox": { "h": 0.02, "w": 0.45, "x": 0.07, "y": 0.34 }, "kind": "paragraph", "text": "MGH expects to cease OCS liver use in next few months", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:25:55.963+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "8e0cffac-83c8-484e-b0bc-04f4ada33209", "parentComponentId": null }, { "bbox": { "h": 0.55, "w": 0.86, "x": 0.07, "y": 0.37 }, "kind": "quote", "text": "A: “Livers have been used less because one of our leading surgeons left... Q: “Do you see a wave coming?” A: “Yeah, that’s what’s going to happen...it’s a no-brainer.” Q: “For livers, probably in the next six months.” A: “I think we’ll probably stop using it...the market has shifted...I would switch right away.” – Veteran transplant administrator at Massachusetts General Hospital", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:25:55.963+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "b9819b91-d0e4-4a47-8491-37a18a83a0ac", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "I think we'll probably stop using it...the idea that their device is the premier and one and only best device that is on the market and that can be used to save human life is not true simply because the market has shifted...the clinicians who have been very, very concerned about the poor business practices and misalignment of incentives with TransMedics, that there are now going to be other technologies that are coming up that actually...it's very promising that there's going to be a different option, not only from the actual product standpoint but just from a business standpoint, I would switch right away. — Veteran transplant administrator at Massachusetts General Hospital", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:21+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a988-6fe7b29b2fba", "parentComponentId": null }, { "bbox": { "h": 0.02, "w": 0.25, "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:25:55.963+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "3bce7189-1516-42ba-a0a8-1a80f78df83a", "parentComponentId": null }, { "bbox": { "h": 0.25, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "title", "text": "Massachusetts General indicated their usage has already dropped off and that they expect to terminate all usage within a few months, indicating a wave as the field is rapidly shifting away from TransMedics due to “clinicians who have been very, very concerned about their poor business practices and misalignment of incentives”: “I would switch right away”; “for liver, probably in the next six months...I think we’ll probably stop using it...it’s gotten to that point....there’s going to be no real utility in using OCS in comparison to other cheaper, more widely-available...it’s a no-brainer.”", "attrs": null, "canon": { "kind": { "name": "Title", "slug": "title", "status": "active", "canonId": "019de52c-f7dd-76d9-b848-b1f12bd85cf4", "version": 1, "description": "Slide title or headline." }, "tool": null, "subkind": { "name": "Headline", "slug": "headline", "status": "active", "canonId": "019de52c-fae1-7463-9a7c-d60668eced0d", "version": 1, "description": null }, "framework": null }, "subkind": "headline", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:25:55.963+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "b3064c17-e6e6-4b75-9e40-6a054517c9f7", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [ { "matchId": "9f9648ac-c288-43dc-ab5f-f0264a5ff660", "evidence": "Citing a veteran transplant administrator at MGH to validate the claim.", "framework": null, "confidence": 0.9, "extraction": { "at": "2026-05-02 21:25:55.963+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 278, "frameworkName": "authority-citation" } ], "arcBeats": [], "loops": [], "locked": true }, { "page": 279, "type": "tension", "title": "The slide uses direct quotes from an UCSF administrator to build a case against TransMedics' long-term viability at the institution.", "function": "expose_contradiction", "rawType": "expose_contradiction", "block": null, "metadata": { "slideType": "expose_contradiction", "slideTypeCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-124c-75aa-984a-0a3d0d8fc8df", "version": 1, "description": null }, "function": "expose_contradiction", "functionCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-171f-776f-887c-73edaff4cf9c", "version": 1, "description": null }, "density": "dense", "densityScore": 64, "componentCount": 7, "textChars": 3398, "nDataPoints": 0, "notes": "The slide uses direct quotes from an UCSF administrator to build a case against TransMedics' long-term viability at the institution.", "elementsJson": [ "paragraph", "quote_block" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 21:25:58.571+00", "seconds": 4.823, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/279", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-279", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "we really don't love doing business with them...they're gouging us...as soon as we can detangle ourselves from them, the better.", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:21+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a988-54f67a46f313", "parentComponentId": null }, { "bbox": { "h": 0.12, "w": 0.86, "x": 0.07, "y": 0.42 }, "kind": "paragraph", "text": "Liver is highest volume and seeking to use other options “whenever possible”\n“The liver program is our highest volume. We, also on the liver side, are interested in doing more NRP and using other devices as alternatives whenever possible...we don’t want to have to rely so heavily on TransMedics...I’m struggling from an administrative standpoint. These costs are really making it challenging for us.” – UCSF administrator", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:25:58.571+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "2200c346-30d6-46ca-9c7f-8347cc6bf1d2", "parentComponentId": null }, { "bbox": { "h": 0.25, "w": 0.86, "x": 0.07, "y": 0.15 }, "kind": "paragraph", "text": "and replied affirmatively when we asked if they expect their usage to “drop off a cliff”: ‘that’s our plan, yeah’; “we’re trying to reduce our utilization”; “we will shorty be up and running with OrganOx...which would negate the need for TransMedics altogether”; “our surgical director is a not a fan...he’s actively working on strategies to minimize our reliance on it”; “we really don’t love doing business with them...they’re gouging us...as soon as we can detangle ourselves from them, the better.” UCSF also indicated they plan to shift aggressively to NRP in addition to OrganOx, with an NRP procurement service starting in Jan 2025 for both liver and heart.", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:25:58.571+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "82e13aee-e736-44a8-96db-4e8dc7951df6", "parentComponentId": null }, { "bbox": { "h": 0.4, "w": 0.86, "x": 0.07, "y": 0.55 }, "kind": "paragraph", "text": "UCSF eliminating TransMedics by early 2025 through combination of OrganOx and NRP\nQ: “Is there a timeline for when you guys think you’ll reduce your usage? You used them 70 times in about the last 12 months - walk me through what the usage has been the last couple of years on liver and where you think it will go.”\nA: “I was just doing this analysis recently because we’re trying to reduce our utilization. We’re trying to identify—our OPO and then our neighboring OPO both recently finally got OrganOX machines, and their staff is being trained right now. Our surgeons are scheduled for training. So, we will shortly be up and running with OrganOX...which would negate the need for TransMedics altogether.”\nQ: “When do you think your NRP usage will eliminate your DCD use of TransMedics?”\nA: “There’s a procurement company that we’ve contracted with for thoracic, and we’re trying to get them to do liver NRP for us. I would suspect that by January 2025, they could be doing NRP for us.”\nQ: “So, theoretically, your usage of TransMedics could fall off the cliff in 2025?”\nA: “That’s our plan, yeah. I hope...for liver transplant, we use it obviously a lot more than heart or lung. I know our surgical director is not a fan of TransMedics and he’s actively working on strategies to minimize our reliance on it. I think the surgeons really like it because of the convenience of being able to send someone out to get the organ for you. But I think everybody’s totally on board with adopting something new, and I can speak for the surgical director; he and I are on the same page. We really don’t love doing business with them and it really does feel like they’re gouging us. And as soon as we can detangle ourselves from them, the better.” – UCSF administrator", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:25:58.571+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "87d25ed1-cf3c-423e-9dd1-a4f8fd5c8305", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "“That’s our plan, yeah. I hope...for liver transplant, we use it obviously a lot more than heart or lung. I know our surgical director is not a fan of TransMedics and he’s actively working on strategies to minimize our reliance on it.” — UCSF administrator", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:21+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a988-5b7151b7e217", "parentComponentId": null }, { "bbox": { "h": 0.03, "w": 0.25, "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:25:58.571+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "6ffde006-c6b0-4c3a-a23c-4511488b376f", "parentComponentId": null }, { "bbox": { "h": 0.15, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "title", "text": "UCSF indicated the same intention as MGH – that they expect to eliminate TransMedics usage starting in early 2025", "attrs": null, "canon": { "kind": { "name": "Title", "slug": "title", "status": "active", "canonId": "019de52c-f7dd-76d9-b848-b1f12bd85cf4", "version": 1, "description": "Slide title or headline." }, "tool": null, "subkind": { "name": "Headline", "slug": "headline", "status": "active", "canonId": "019de52c-fae1-7463-9a7c-d60668eced0d", "version": 1, "description": null }, "framework": null }, "subkind": "headline", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:25:58.571+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "b405d4d4-db50-407a-b5c9-e1cdfc6b08d6", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [], "arcBeats": [], "loops": [], "locked": true }, { "page": 280, "type": "setup", "title": "The slide uses highlighted text to emphasize key negative sentiment regarding TransMedics' sustainability and market position.", "function": "preempt_rebuttal", "rawType": "preempt_rebuttal", "block": null, "metadata": { "slideType": "preempt_rebuttal", "slideTypeCanon": { "name": "Preempt rebuttal", "slug": "preempt_rebuttal", "status": "active", "canonId": "019de52d-1225-7368-af32-6381fddabdb3", "version": 1, "description": null }, "function": "preempt_rebuttal", "functionCanon": { "name": "Preempt rebuttal", "slug": "preempt_rebuttal", "status": "active", "canonId": "019de52d-18ab-7479-9a7e-820a2f03586a", "version": 1, "description": null }, "density": "balanced", "densityScore": 47, "componentCount": 6, "textChars": 1312, "nDataPoints": 1, "notes": "The slide uses highlighted text to emphasize key negative sentiment regarding TransMedics' sustainability and market position.", "elementsJson": [ "paragraph", "quote_block" ], "confidence": 0.95, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 21:26:00.571+00", "seconds": 6.262, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/280", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-280", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "It's probably 90% down from last year...I could put you in touch with a lot of people that are just going to say the same thing, 'I hate TransMedics....I had recently had a conversation with the surgeon from our local OPO because I fly with them often for Paragonix. It's the same thing over and over again, just TransMedics, we don't see them being here in a year.'", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:22+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a989-41d8d5b6ebe4", "parentComponentId": null }, { "bbox": { "h": 0.35, "w": 0.86, "x": 0.07, "y": 0.35 }, "kind": "paragraph", "text": "Cost is \"unsustainable\" for UW; moving to NRP. Q: \"You heard some scuttlebutt about how UW is thinking about moving away from them and that there was a meeting about this?\" A: \"It's cost. It's just not sustainable...\"", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:26:00.571+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "000cef69-2913-45fc-a173-76f656166b75", "parentComponentId": null }, { "bbox": { "h": 0.22, "w": 0.86, "x": 0.07, "y": 0.72 }, "kind": "paragraph", "text": "UW reducing use; already down 90%; \"we don't see them being here in a year\". \"Our lung surgeon won't use TransMedics... It's probably 90% down from last year...\"", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:26:00.571+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "7c5db581-0e19-40b8-b293-a6e9ae933e4a", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "I could put you in touch with a lot of people that are just going to say the same thing....'I hate TransMedics,' the OPO's, the hospitals...it's the same thing over and over again...we just don't see them being here in a year. — Organ procurement technician at a high-volume Northwest academic transplant center", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:22+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a989-44b42f421bc1", "parentComponentId": null }, { "bbox": { "h": 0.03, "w": 0.25, "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:26:00.571+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "77d0a461-e047-4339-ac4f-196acc40ba90", "parentComponentId": null }, { "bbox": { "h": 0.25, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "title", "text": "An University of Washington source stated that their use of OCS devices has dropped 90% in the last year, and that NRP and other devices like Paragonix and XVIVO will wipe out TransMedics within a year", "attrs": null, "canon": { "kind": { "name": "Title", "slug": "title", "status": "active", "canonId": "019de52c-f7dd-76d9-b848-b1f12bd85cf4", "version": 1, "description": "Slide title or headline." }, "tool": null, "subkind": { "name": "Headline", "slug": "headline", "status": "active", "canonId": "019de52c-fae1-7463-9a7c-d60668eced0d", "version": 1, "description": null }, "framework": null }, "subkind": "headline", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:26:00.571+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "e36e0c33-a8c4-4c32-b69f-7fa46598de87", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [ { "matchId": "f9b5bee0-aa8e-44ad-9196-731cacf0daff", "evidence": "Uses expert testimony to undermine the target company's market viability.", "framework": null, "confidence": 0.9, "extraction": { "at": "2026-05-02 21:26:00.571+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 280, "frameworkName": "preempt_rebuttal" } ], "arcBeats": [], "loops": [], "locked": true }, { "page": 281, "type": "tension", "title": "This slide serves as a highly critical, accusatory statement against the subject company.", "function": "name_villain", "rawType": "villain_critique", "block": null, "metadata": { "slideType": "villain_critique", "slideTypeCanon": { "name": "Villain critique", "slug": "villain_critique", "status": "active", "canonId": "019de52d-10bc-7136-bf20-09de59d17447", "version": 1, "description": null }, "function": "name_villain", "functionCanon": { "name": "Name villain", "slug": "name_villain", "status": "active", "canonId": "019de52d-1746-70d6-bc58-5eeaf5865526", "version": 1, "description": null }, "density": "sparse", "densityScore": 11, "componentCount": 2, "textChars": 526, "nDataPoints": 0, "notes": "This slide serves as a highly critical, accusatory statement against the subject company.", "elementsJson": [ "paragraph" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 21:25:56.412+00", "seconds": 2.057, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/281", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-281", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "Part 12. TransMedics device has no value proposition. Even its largest customers admit it has no clinical benefit to organs, using it off-label strictly for “surgeon lifestyle” and scheduling convenience; or, we believe, in exchange for organs steered improperly.", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:20+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a987-bf8031bd8d51", "parentComponentId": null }, { "bbox": { "h": 0.135, "w": 0.854, "x": 0.073, "y": 0.07 }, "kind": "paragraph", "text": "Part 12. TransMedics device has no value proposition. Even its largest customers admit it has no clinical benefit to organs, using it off-label strictly for “surgeon lifestyle” and scheduling convenience; or, we believe, in exchange for organs steered improperly.", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:25:56.412+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "a1ed2cc7-c56a-45a0-a4e0-efa934715138", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [], "arcBeats": [], "loops": [], "locked": true }, { "page": 282, "type": "tension", "title": "The slide uses a testimonial from a transplant surgeon to support a bearish thesis on the company's market position.", "function": "name_villain", "rawType": "villain_critique", "block": null, "metadata": { "slideType": "villain_critique", "slideTypeCanon": { "name": "Villain critique", "slug": "villain_critique", "status": "active", "canonId": "019de52d-10bc-7136-bf20-09de59d17447", "version": 1, "description": null }, "function": "name_villain", "functionCanon": { "name": "Name villain", "slug": "name_villain", "status": "active", "canonId": "019de52d-1746-70d6-bc58-5eeaf5865526", "version": 1, "description": null }, "density": "dense", "densityScore": 52, "componentCount": 5, "textChars": 2645, "nDataPoints": 1, "notes": "The slide uses a testimonial from a transplant surgeon to support a bearish thesis on the company's market position.", "elementsJson": [ "paragraph", "quote_block", "footnote" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 21:25:58.21+00", "seconds": 3.671, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/282", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-282", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "In reality, it is a one-trick pony in liver, with zero chance in kidney, the most widely transplanted organ by orders of magnitude; OCS Lung, run by the CEO’s sister, is a colossal failure; and OCS Heart is currently in freefall.", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:21+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a989-13d6f4757bd4", "parentComponentId": null }, { "bbox": { "h": 0.52, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "paragraph", "text": "The TMDX bull case is that the OCS pump is a multi-organ platform for lung, heart, liver, with kidney in development, that revolutionizes transport, preservation, and monitoring. In reality, it is a one-trick pony in liver, with zero chance in kidney, the most widely transplanted organ by orders of magnitude; OCS Lung, run by the CEO’s sister, is a colossal failure; and OCS Heart is currently in freefall. That leaves only OCS Liver, a gimmick used not for any clinical benefit but for a) off-label use for scheduling; b) by questionable centers whom we believe receive kickbacks and organs in exchange for taking them on the device. We cover each organ in turn – starting with the failure of OCS in Europe, the canary in the coal mine – proof that it exists in the US solely due to a Medicare loophole. The head of a large transplant center: “You should look at the European market...you know what market share TransMedics has in Europe? Zero because they understand that they don’t have a shot at competing...there are so many competitors and options...they cost 20% of TransMedics.”", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:25:58.21+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "98b52c3e-0c1a-447b-b98b-097db5d450fa", "parentComponentId": null }, { "bbox": { "h": 0.25, "w": 0.86, "x": 0.07, "y": 0.59 }, "kind": "quote", "text": "No market opportunity for TransMedics in Europe\n“To do your due diligence, you should look at the European market. The Europeans have been using pumps a lot longer than the Americans and they use a variety of different pumps at their disposal: normothermic, hypothermic. And you know what market share TransMedics has in Europe? Zero because they understand that they don’t have a shot at competing in the European market because there are so many other competitors and options for a transplant center to use that are much cheaper. They cost 20% of TransMedics.” – Transplant surgeon and division head at a major transplant center; high-volume TransMedics user", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:25:58.21+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "363e48f4-cd19-4766-a517-b4f123cf91ad", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "“To do your due diligence, you should look at the European market. The Europeans have been using pumps a lot longer than the Americans and they use a variety of different pumps at their disposal: normothermic, hypothermic. And you know what market share TransMedics has in Europe? Zero because they understand that they don’t have a shot at competing in the European market because there are so many other competitors and options for a transplant center to use that are much cheaper. They cost 20% of TransMedics.” — Transplant surgeon and division head at a major transplant center; high-volume TransMedics user", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:21+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a989-151949b8503e", "parentComponentId": null }, { "bbox": { "h": 0.03, "w": 0.3, "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:25:58.21+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "044b61a4-88d7-464a-90e3-b4f9a0bedd39", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [], "arcBeats": [], "loops": [], "locked": true }, { "page": 283, "type": "tension", "title": "The slide uses direct quotes from KOLs to frame the company's technology as a commoditized, overpriced solution with no clinical advantage over traditional cold", "function": "name_villain", "rawType": "villain_critique", "block": null, "metadata": { "slideType": "villain_critique", "slideTypeCanon": { "name": "Villain critique", "slug": "villain_critique", "status": "active", "canonId": "019de52d-10bc-7136-bf20-09de59d17447", "version": 1, "description": null }, "function": "name_villain", "functionCanon": { "name": "Name villain", "slug": "name_villain", "status": "active", "canonId": "019de52d-1746-70d6-bc58-5eeaf5865526", "version": 1, "description": null }, "density": "dense", "densityScore": 72, "componentCount": 8, "textChars": 3499, "nDataPoints": 0, "notes": "The slide uses direct quotes from KOLs to frame the company's technology as a commoditized, overpriced solution with no clinical advantage over traditional cold storage.", "elementsJson": [ "paragraph", "quote_block" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 21:25:59.59+00", "seconds": 4.816, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/283", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-283", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": { "h": 0.03, "w": 0.35, "x": 0.07, "y": 0.47 }, "kind": "callout", "text": "Zero value proposition; no difference in outcomes; no TAM", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": null, "subkind": { "name": "Primary callout", "slug": "primary", "status": "active", "canonId": "019de52c-fbd1-70eb-a9ce-8997f8674c1d", "version": 1, "description": null }, "framework": null }, "subkind": "primary", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:25:59.59+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "ebd03673-517e-455c-9e09-3df0b80d95f0", "parentComponentId": null }, { "bbox": null, "kind": "callout", "text": "One leading center after another indicated that the OCS platform is a commodity with no value proposition, detailing why it failed in heart and lung, and why liver is next.", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:21+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a988-b2e50906ebb4", "parentComponentId": null }, { "bbox": { "h": 0.25, "w": 0.86, "x": 0.07, "y": 0.2 }, "kind": "paragraph", "text": "One of the world's top liver transplant surgeons, perhaps the most influential KOL in the field, sharply criticized its use and indicated it has zero clinical benefit: “the problem with the market is that they’ve expanded use which doesn’t need to be expanded...it’s ridiculous...you’re replacing a very cheap technology that costs a few thousand dollars with one that costs $100,000”; “patient and graft survival are no different between cold storage and machine perfusion.” A transplant physician at Massachusetts General called it a commodity: “I don’t think there’s any magic to TransMedics...it’s got cute bells and whistles...let’s face it: there’s no secret sauce here”; and that it will be replaced shortly with devices that are “...a whole lot less costly, then you do that way...there’s no question...I think there will be a low threshold to jump over.”", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:25:59.59+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "70f37625-bde4-4839-88fa-33f5af61e92c", "parentComponentId": null }, { "bbox": { "h": 0.2, "w": 0.86, "x": 0.07, "y": 0.73 }, "kind": "quote", "text": "MGH calls perfusion pumps a commodity\n“I don’t think there’s any magic to TransMedics per se. It’s got cute bells and whistles; it travels. Let’s face it: there’s no secret sauce in this. Perfusion is in many ways perfusion and, in this case, normothermic perfusion is normothermic perfusion. It would be very hard to ascribe a special quality to one modality necessarily over another. If you can get that with one device comparably to another and logistically it’s less challenging and certainly a whole lot less costly, then you go that way, there’s no question. So, I think there will be a low threshold to jump over.” - Transplant hepatologist at Massachusetts General Hospital", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:25:59.59+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "a06f0be9-4761-45fc-8dfc-60a6d31812f1", "parentComponentId": null }, { "bbox": { "h": 0.2, "w": 0.86, "x": 0.07, "y": 0.51 }, "kind": "quote", "text": "A: “The problem with the marketing is that they’ve expanded use which doesn’t need to be expanded. In other words, they’re talking about an $8 billion industry. That means that every organ would be pumped on the machine at $100,000; it’s ridiculous. You’re replacing a very cheap technology that costs a few thousand dollars with ne that costs $100,000.” Q: “You’re saying the device really doesn’t add value beyond the traditional method of cold storage.” A: “No, not for every organ because the pristine, what we call blue ribbon organs, they do perfectly fine. One thing that you can take away from all of these studies also is that the patient and graft survival are no different between the cold storage and machine perfusion...there was already a trend towards improved outcomes before the machines came out.” - One of the top liver transplant surgeons in the world, based at a leading academic center", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:25:59.59+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "f4e1a6ac-2e9b-4ebd-bdcf-1f61b9504c86", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "“the problem with the market is that they’ve expanded use which doesn’t need to be expanded...it’s ridiculous...you’re replacing a very cheap technology that costs a few thousand dollars with one that costs $100,000”; “patient and graft survival are no different between cold storage and machine perfusion.” — One of the top liver transplant surgeons in the world, based at a leading academic center. “I don’t think there’s any magic to TransMedics...it’s got cute bells and whistles...let’s face it: there’s no secret sauce here” — Transplant hepatologist at Massachusetts General Hospital.", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:21+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a988-b5b2bf76e68c", "parentComponentId": null }, { "bbox": { "h": 0.02, "w": 0.25, "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:25:59.59+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "57ffce99-c6f6-4829-bef6-33dbad76283d", "parentComponentId": null }, { "bbox": { "h": 0.12, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "title", "text": "One leading center after another indicated that the OCS platform is a commodity with no value proposition, detailing why it failed in heart and lung, and why liver is next.", "attrs": null, "canon": { "kind": { "name": "Title", "slug": "title", "status": "active", "canonId": "019de52c-f7dd-76d9-b848-b1f12bd85cf4", "version": 1, "description": "Slide title or headline." }, "tool": null, "subkind": { "name": "Headline", "slug": "headline", "status": "active", "canonId": "019de52c-fae1-7463-9a7c-d60668eced0d", "version": 1, "description": null }, "framework": null }, "subkind": "headline", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:25:59.59+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "34927e9b-e0cc-4758-bcf4-a04822e50985", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [], "arcBeats": [], "loops": [], "locked": true }, { "page": 284, "type": "tension", "title": "The slide uses direct quotes from a KOL to undermine the company's market position.", "function": "expose_contradiction", "rawType": "expose_contradiction", "block": null, "metadata": { "slideType": "expose_contradiction", "slideTypeCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-124c-75aa-984a-0a3d0d8fc8df", "version": 1, "description": null }, "function": "expose_contradiction", "functionCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-171f-776f-887c-73edaff4cf9c", "version": 1, "description": null }, "density": "overcrowded", "densityScore": 94, "componentCount": 12, "textChars": 2999, "nDataPoints": 8, "notes": "The slide uses direct quotes from a KOL to undermine the company's market position.", "elementsJson": [ "paragraph", "quote_block", "footnote" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 21:26:00.025+00", "seconds": 4.695, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/284", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-284", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "One of the largest transplant programs basically uses no TransMedics", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:21+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a988-f846014473ee", "parentComponentId": null }, { "bbox": { "h": 0.03, "w": 0.9, "x": 0.05, "y": 0.32 }, "kind": "paragraph", "text": "One of the largest transplant programs basically uses no TransMedics", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:26:00.025+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "60c14d82-787b-4bb7-bd12-9bb87cadc646", "parentComponentId": null }, { "bbox": { "h": 0.03, "w": 0.9, "x": 0.05, "y": 0.89 }, "kind": "paragraph", "text": "No use in liver, use OrganOX instead due to cost", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:26:00.025+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "7bfd6b3e-02d9-461b-a375-a3dbcfe86138", "parentComponentId": null }, { "bbox": { "h": 0.03, "w": 0.9, "x": 0.05, "y": 0.51 }, "kind": "paragraph", "text": "Lung use went from 50% to zero; none in 4-6 months", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:26:00.025+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "990688dd-3a42-4937-aece-84214682ef69", "parentComponentId": null }, { "bbox": { "h": 0.03, "w": 0.9, "x": 0.05, "y": 0.7 }, "kind": "paragraph", "text": "Still have lung devices unused from 4 years ago; last lung case on TransMedics was almost a year ago", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:26:00.025+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "c85e48dd-87c2-4839-84f6-f8f15993955a", "parentComponentId": null }, { "bbox": { "h": 0.12, "w": 0.9, "x": 0.05, "y": 0.36 }, "kind": "quote", "text": "We are a multi-organ transplant program at the University of Chicago. We do about 100 liver transplants a year, 200 kidney transplants, and about 60 hearts. We probably will do about 15 or 20 lungs this year. I do primarily liver. But I'm the [redacted] of the transplant institute, so I work closely with all the other programs...we transplant 60-65 hearts a year. We just started doing the DCDs about two and a half years ago now. And we've been using the NOP DCD program that TransMedics has for about 4-5 cases a year. The new director isn't planning to use it in many cases. So, we expect to drop off. And then for liver, we don't use it at all.", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:26:00.025+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "077c7f65-1ed8-4236-b10e-9b20759fca9b", "parentComponentId": null }, { "bbox": { "h": 0.06, "w": 0.9, "x": 0.05, "y": 0.93 }, "kind": "quote", "text": "For livers, we don't use it at all. We use OrganOX. When TransMedics approached us for the combination heart-lung-liver, we viewed the contract and the pluses and minuses, and we eventually ended up going with OrganOX for liver...it was primarily a decision that was based on cost.", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:26:00.025+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "80ba7259-4af2-497a-9187-6496340f7b45", "parentComponentId": null }, { "bbox": { "h": 0.12, "w": 0.9, "x": 0.05, "y": 0.55 }, "kind": "quote", "text": "We were using them for lungs. Our director has already said he's probably not going to use TransMedics to any great extent. So, we would anticipate a drop-off in TransMedics use in lungs. About five years ago, we went to TransMedics and we were using them for about 50% of our lung transplants that year. Our practice is primarily using Paragonix for the preservation of lungs. So, he doesn't pump the lungs that he's transplanting now.", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:26:00.025+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "94806305-bbad-47eb-b079-b55d69f8f462", "parentComponentId": null }, { "bbox": { "h": 0.12, "w": 0.9, "x": 0.05, "y": 0.74 }, "kind": "quote", "text": "The lungs, we have units still left over from four years ago. We haven't done a lung transplant on TransMedics, probably in about four to six months....originally, when we contracted with them, you had to buy 10 units. So, you basically stored them in your storage area...the last time we did a lung on TransMedics was close to 9 to 12 months ago...I haven't tried to replenish our stock. I think we may still have units left over from the past.", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:26:00.025+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "a451537d-986b-485b-89fe-fb7321e37e62", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "“For livers, we don't use it at all...we use OrganOX” — Leading liver transplant surgeon/KOL", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:21+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a988-ffe7091ff469", "parentComponentId": null }, { "bbox": { "h": 0.02, "w": 0.3, "x": 0.05, "y": 0.97 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:26:00.025+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "488535a0-17c6-4709-902c-0d2ef9a77a89", "parentComponentId": null }, { "bbox": { "h": 0.25, "w": 0.9, "x": 0.05, "y": 0.05 }, "kind": "title", "text": "A transplant surgery KOL at the University of Chicago trashed the OCS pump for liver, heart, and kidney - every TransMedics product - stating they are a massive program that transplants 100 livers, 60 hearts, and 15-20 lungs per year, but see no value in liver; lung use dropped from 50% share to nothing; and that they still have a few units left over from 4 years ago when TransMedics forced them to buy 10 consumables - “for liver, we don’t use it all…we use OrganOX”; “we were using them for about 50% of our lung transplants…the last time we did a lung on TransMedics was close to 9 to 12 months ago”; and that for heart “the new director isn’t planning to use it in many case…we expect to drop off.”", "attrs": null, "canon": { "kind": { "name": "Title", "slug": "title", "status": "active", "canonId": "019de52c-f7dd-76d9-b848-b1f12bd85cf4", "version": 1, "description": "Slide title or headline." }, "tool": null, "subkind": { "name": "Headline", "slug": "headline", "status": "active", "canonId": "019de52c-fae1-7463-9a7c-d60668eced0d", "version": 1, "description": null }, "framework": null }, "subkind": "headline", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:26:00.025+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "ace9bb83-2a05-41e6-8277-d8bcac684528", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [], "arcBeats": [], "loops": [], "locked": true }, { "page": 285, "type": "tension", "title": "The slide uses a 'villain critique' approach by aggregating expert opinions to undermine the company's value proposition.", "function": "expose_contradiction", "rawType": "testimonial", "block": null, "metadata": { "slideType": "testimonial", "slideTypeCanon": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52d-0a2d-7782-8a48-7e84df92cc97", "version": 1, "description": null }, "function": "expose_contradiction", "functionCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-171f-776f-887c-73edaff4cf9c", "version": 1, "description": null }, "density": "dense", "densityScore": 73, "componentCount": 8, "textChars": 4105, "nDataPoints": 0, "notes": "The slide uses a 'villain critique' approach by aggregating expert opinions to undermine the company's value proposition.", "elementsJson": [ "paragraph", "quote_block" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 21:26:04.582+00", "seconds": 8.831, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/285", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-285", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "Our liver transplant surgeons don't use TransMedics...a lot of people don't think you need it on the liver...cold storage works very, very well...ischemic times can be 8 hours...our liver guys are not interested in using it at all.", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:22+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a989-6b93b67f56c5", "parentComponentId": null }, { "bbox": { "x": 0.07, "y": 0.07 }, "kind": "paragraph", "text": "We quote three other surgeons as well as an executive at one of the largest OPO's in the US, who provided equally damning color on the lack of any value proposition and TransMedics dismal future – we note two of the below are among its highest-volume users, suggesting its precarious position. One stated “our liver transplant surgeons don't use TransMedics...a lot of people don't think you need it on the liver...cold storage works very, very well...ischemic times can be 8 hours...our liver guys are not interested in using it at all.” A high-volume liver user stated “our heart surgeons...do not care much for the machine...they're going to continue to lose cardiac volume.” An OPO executive confirmed that “there's not a ton of utilization of their heard device out here on the West Coast.” And one of its top liver users stated cold storage is just fine – “you don't need the Cadillac to transport the organ...you can get by with a less expensive version.”", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:26:04.582+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "b65097aa-47ee-439f-8a87-1e787741d61f", "parentComponentId": null }, { "bbox": { "x": 0.07, "y": 0.48 }, "kind": "quote", "text": "Cold storage works fine for liver: “Our liver transplant surgeons don't use TransMedics. I think a lot of people don't think you need it on the liver. Cold storage works very, very well. Ischemic times can be 8 hours. They've turned that operation into a quasi-elective case...Our liver guys are not interested at all in using it.” – Cardiac transplant surgeon at a major Midwest academic center", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:26:04.582+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "46b08cc3-5461-4b98-b768-613eadf944a6", "parentComponentId": null }, { "bbox": { "x": 0.07, "y": 0.61 }, "kind": "quote", "text": "Ice and cheap machines are sufficient for liver: “TransMedics and OrganOX are examples of normothermic machine perfusion, which is the most expensive way to preserve an organ. Less effective in preservation but still pretty good is something called hypothermic machine perfusion, for example, Bridge to Life or LifePort. And that costs significantly less. It provides better preservation than just putting it in a cooler of ice. But for many cases, you don't need the Cadillac to transport the organ. You can get by with a less expensive version.” – Transplant surgeon and transplant program director at a leading Northeast academic center", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:26:04.582+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "7f251ae6-ec84-4ee8-b6d5-ac467c94a39f", "parentComponentId": null }, { "bbox": { "x": 0.07, "y": 0.85 }, "kind": "quote", "text": "Cardiac surgeons have no interest in TransMedics pump: “I do think and I hear the same from our heart surgeons. They do not care much for the machine and prefer other modalities for their hearts...they're going to continue to lose cardiac volume.” -Transplant surgeon at a high-volume academic center", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:26:04.582+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "c6aac96d-1dc5-4f87-a3c8-86611ef67738", "parentComponentId": null }, { "bbox": { "x": 0.07, "y": 0.78 }, "kind": "quote", "text": "Minimal heart use left on West Coast: “There's not a ton of utilization of their heart device out here on the West Coast...” – Executive at a leading OPO, longtime industry veteran", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:26:04.582+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "c9bc85bc-7b3b-44e9-9d08-51a46b372ec9", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "\"Our liver transplant surgeons don't use TransMedics. I think a lot of people don't think you need it on the liver. Cold storage works very, very well. Ischemic times can be 8 hours. They've turned that operation into a quasi-elective case...Our liver guys are not interested at all in using it.\" — Cardiac transplant surgeon at a major Midwest academic center; \"TransMedics and OrganOX are examples of normothermic machine perfusion, which is the most expensive way to preserve an organ. Less effective in preservation but still pretty good is something called hypothermic machine perfusion, for example, Bridge to Life or LifePort. And that costs significantly less. It provides better preservation than just putting it in a cooler of ice. But for many cases, you don't need the Cadillac to transport the organ. You can get by with a less expensive version.\" — Transplant surgeon and transplant program director at a leading Northeast academic center; \"There's not a ton of utilization of their heart device out here on the West Coast.\" — Executive at a leading OPO, longtime industry veteran; \"I do think and I hear the same from our heart surgeons. They do not care much for the machine and prefer other modalities for their hearts...they're going to continue to lose cardiac volume.\" — Transplant surgeon at a high-volume academic center", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:22+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a989-6d3863a1b14e", "parentComponentId": null }, { "bbox": { "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:26:04.582+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "7a4751b2-85dd-422f-bebd-6d68d13e0490", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [], "arcBeats": [], "loops": [], "locked": true }, { "page": 286, "type": "tension", "title": "The slide uses a Q&A format to highlight the gap between the device's intended utility and real-world clinical experience.", "function": "expose_contradiction", "rawType": "expose_contradiction", "block": null, "metadata": { "slideType": "expose_contradiction", "slideTypeCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-124c-75aa-984a-0a3d0d8fc8df", "version": 1, "description": null }, "function": "expose_contradiction", "functionCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-171f-776f-887c-73edaff4cf9c", "version": 1, "description": null }, "density": "overcrowded", "densityScore": 86, "componentCount": 11, "textChars": 2942, "nDataPoints": 0, "notes": "The slide uses a Q&A format to highlight the gap between the device's intended utility and real-world clinical experience.", "elementsJson": [ "paragraph", "quote_block", "footnote" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 21:26:00.238+00", "seconds": 4.464, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/286", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-286", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "Surgeons provided devastating color that there is no correlation between how organs look on the pump and how they turn out in the recipient - that organs that look great may fail, and that organs which look questionable on the pump have performed fine.", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:21+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a988-9976ac1b17c8", "parentComponentId": null }, { "bbox": { "h": 0.03, "w": 0.85, "x": 0.07, "y": 0.65 }, "kind": "list", "text": "No correlation between organ performance on pump and after transplant", "attrs": null, "canon": { "kind": { "name": "List", "slug": "list", "status": "active", "canonId": "019de52c-f94b-779b-a53b-fd4904a5f4d2", "version": 1, "description": "Bullet or numbered list." }, "tool": null, "subkind": { "name": "Bullet list", "slug": "bullet", "status": "active", "canonId": "019de52c-fc98-7169-a083-5cab805076ca", "version": 1, "description": null }, "framework": null }, "subkind": "bullet", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:26:00.238+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "2a19557c-6a9e-451f-9e75-c8fb4bcbeea2", "parentComponentId": null }, { "bbox": { "h": 0.15, "w": 0.85, "x": 0.07, "y": 0.19 }, "kind": "paragraph", "text": "Surgeons provided devastating color that there is no correlation between how organs look on the pump and how they turn out in the recipient – that organs that look great may fail, and that organs which look questionable on the pump have performed fine.", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:26:00.238+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "02243662-4325-43ea-81ac-6896570a0eca", "parentComponentId": null }, { "bbox": { "h": 0.15, "w": 0.85, "x": 0.07, "y": 0.34 }, "kind": "paragraph", "text": "A liver transplant surgeon who runs a major program stated no one knows how to use the machine data, indicating cases where “the data from the machine has been good, but we have a liver that it not good in the end...so we don’t have perfect data to tell us whether a liver is going to be good or not.”", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:26:00.238+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "aaae19c5-1845-4fee-8ede-d66d2cfca58e", "parentComponentId": null }, { "bbox": { "h": 0.15, "w": 0.85, "x": 0.07, "y": 0.49 }, "kind": "paragraph", "text": "He noted the confusion exists despite almost a decade of study and use since the clinical trials started – “there’s still not enough data that can tell us when something’s good...so you get a lot of surgeon cross-talk....’What should I do? Should I give it more time? Should I dump it?’....we’re still trying to sort that out.”", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:26:00.238+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "fb7c58d2-3e76-48c5-bf68-ec7a2a47e08c", "parentComponentId": null }, { "bbox": { "h": 0.08, "w": 0.85, "x": 0.07, "y": 0.78 }, "kind": "quote", "text": "Q: “I talked to a cardiac transplant surgeon. He also said that there’s no correlation between how well a heart pumps, how it looks once you put it on the pump versus what ends up happening when you implant it. So, they’ve seen cases where it didn’t look good at all, and it ended up being great, and cases where it looked great, and it was a disaster. Is that what you’re observing?”", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:26:00.238+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "83e9a776-7f53-4e93-9ba6-0bee94bf1428", "parentComponentId": null }, { "bbox": { "h": 0.1, "w": 0.85, "x": 0.07, "y": 0.68 }, "kind": "quote", "text": "A: “They have a specialist that’s with the machine and the organ at all times and you’re checking labs hourly. And so it requires a lot of manpower to manage. I would say that we’ve had a few cases where all of the data from the machine has been good, but we still have a liver that is not good in the end. And so we don’t have perfect data to tell us whether a liver is going to be a good liver or not..”", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:26:00.238+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "8b15a3d8-f2b8-4b38-ad6d-5cebc37b5d2b", "parentComponentId": null }, { "bbox": { "h": 0.1, "w": 0.85, "x": 0.07, "y": 0.86 }, "kind": "quote", "text": "A: “Yeah, I would say that is true and it’s such a novel device even though it’s been out and we’ve had a trial and everything. There’s still not enough data that can tell us when something’s good or not. And so, you get a lot of surgeon cross-talk, people talking to one another, high-volume users saying I’ve got this scenario on the device. Would you use that? Or what would you do? What should I do? Should I give it more time? Should I dump it? I think we’re still trying to sort that out...” - Transplant surgeon at a high-volume West Coast academic center", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:26:00.238+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "c68a5513-3751-4ed8-8159-27292f53fcde", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "“the data from the machine has been good, but we have a liver that it not good in the end...so we don’t have perfect data to tell us whether a liver is going to be good or not.” — Transplant surgeon at a high-volume West Coast academic center", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:21+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a988-9d30a24c4a5b", "parentComponentId": null }, { "bbox": { "h": 0.02, "w": 0.3, "x": 0.07, "y": 0.97 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:26:00.238+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "edc59d55-16c1-4157-bc58-2487164ab8f8", "parentComponentId": null }, { "bbox": { "h": 0.12, "w": 0.85, "x": 0.07, "y": 0.07 }, "kind": "title", "text": "Both heart/lung and liver transplant surgeons undermined the fundamental premise of the pump", "attrs": null, "canon": { "kind": { "name": "Title", "slug": "title", "status": "active", "canonId": "019de52c-f7dd-76d9-b848-b1f12bd85cf4", "version": 1, "description": "Slide title or headline." }, "tool": null, "subkind": { "name": "Headline", "slug": "headline", "status": "active", "canonId": "019de52c-fae1-7463-9a7c-d60668eced0d", "version": 1, "description": null }, "framework": null }, "subkind": "headline", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:26:00.238+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "299c45ad-619f-45b3-9540-fdaba7b0f756", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [], "arcBeats": [], "loops": [], "locked": true }, { "page": 287, "type": "tension", "title": "The slide uses highlighted text to emphasize key negative findings regarding the OCS technology's performance metrics.", "function": "name_villain", "rawType": "villain_critique", "block": null, "metadata": { "slideType": "villain_critique", "slideTypeCanon": { "name": "Villain critique", "slug": "villain_critique", "status": "active", "canonId": "019de52d-10bc-7136-bf20-09de59d17447", "version": 1, "description": null }, "function": "name_villain", "functionCanon": { "name": "Name villain", "slug": "name_villain", "status": "active", "canonId": "019de52d-1746-70d6-bc58-5eeaf5865526", "version": 1, "description": null }, "density": "dense", "densityScore": 72, "componentCount": 8, "textChars": 3291, "nDataPoints": 0, "notes": "The slide uses highlighted text to emphasize key negative findings regarding the OCS technology's performance metrics.", "elementsJson": [ "paragraph", "quote_block" ], "confidence": 0.95, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 21:26:00.429+00", "seconds": 4.357, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/287", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-287", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": { "h": 0.03, "w": 0.45, "x": 0.07, "y": 0.46 }, "kind": "callout", "text": "Organ performance on pump has no correlation with organ viability", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": null, "subkind": { "name": "Primary callout", "slug": "primary", "status": "active", "canonId": "019de52c-fbd1-70eb-a9ce-8997f8674c1d", "version": 1, "description": null }, "framework": null }, "subkind": "primary", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:26:00.429+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "c03786ca-1866-4760-8a22-9b8d03afd333", "parentComponentId": null }, { "bbox": { "h": 0.03, "w": 0.45, "x": 0.07, "y": 0.77 }, "kind": "callout", "text": "No predictive value or value proposition even for marginal DCD hearts", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": null, "subkind": { "name": "Primary callout", "slug": "primary", "status": "active", "canonId": "019de52c-fbd1-70eb-a9ce-8997f8674c1d", "version": 1, "description": null }, "framework": null }, "subkind": "primary", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:26:00.429+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "fbac6e1e-7d5b-4ecb-8c89-17cc7c7cd5d1", "parentComponentId": null }, { "bbox": { "h": 0.25, "w": 0.86, "x": 0.07, "y": 0.19 }, "kind": "paragraph", "text": "A transplant cardiologist at Vanderbilt – the world’s busiest heart transplant institution – indicted the same lack of predictive benefit for assessing hearts as for livers: “we haven’t seen anecdotally a correlation between how well it looks on the rig and how it does in the recipient”; “it was sold initially that...it’s a beating heart to see how it performs over time during transport...we’ve really noticed that is that there doesn’t seem to be a strong correlation between how the heart is performing on the OCS machine and how it does in the recipient after implantation....we’ve had some great-looking hearts clearing lactate, and these patients just crashed and burned horribly....so, while it is a selling point...we haven’t found the trend to be always accurate....”", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:26:00.429+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "78dcf6ed-58f0-4234-911e-14607bab5bb0", "parentComponentId": null }, { "bbox": { "h": 0.12, "w": 0.86, "x": 0.07, "y": 0.81 }, "kind": "paragraph", "text": "Q: “When you said you don’t use it for marginal hearts anymore; that’s just because it doesn’t help you predictively?”\nA: “In part because we haven’t seen anecdotally a correlation between how well it looks on the rig versus how it does in the recipient. And then, two, there’s just been more and more observational research data coming out and in our experience that even if the heart looks marginal based on other clinical characteristics of the donor...we can reasonably predict how well that heart’s going to do in the coming 72 hours.” - Transplant cardiologist at one of the top centers in the US/world", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:26:00.429+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "e25fe64c-e6d9-4f05-8d9d-c195e72ad52f", "parentComponentId": null }, { "bbox": { "h": 0.25, "w": 0.86, "x": 0.07, "y": 0.5 }, "kind": "quote", "text": "“It was sold initially hat unlike most of our procurement methods, there’s a physiological perfusion...it’s a beating heart to see how it performs over time during transport. All of these indirect indicators show that perhaps, even though it looks marginal initially on our echocardiograms or in the donor’s chest, that this year will probably do okay if you gave it a little bit of time after we implant it in the recipient and get them through those early first couple of days or so. But that’s one potential selling point. This is something we speak about with our surgeons all the time - one of the things we’ve really noticed is that there doesn’t seem to be a strong correlation between how the heart is performing on the OCS machines and how it does in the recipient after implantation. We’ve had some that look really crappy by the time they showed up to the recipient operating. But at this point, we’re already in the chest, so we have to go through with it, and we’ve been pleasantly surprised at how well that heart did afterwards. On the flip side, we’ve had some great-looking hearts on the machine with clearing lactate, and these patients just crashed and burned horribly afterwards. So, while it is a selling point...we haven’t found the trend to be always accurate.” -Transplant cardiologist at one of the top centers in the US/world", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:26:00.429+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "322a9f9c-3664-4750-b18c-321661c80576", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "“we haven't seen anecdotally a correlation between how well it looks on the rig and how it does in the recipient” — Transplant cardiologist at one of the top centers in the US/world", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:21+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a988-cbc3f95a6388", "parentComponentId": null }, { "bbox": { "h": 0.02, "w": 0.25, "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:26:00.429+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "d76e700d-f958-450f-a3b9-d78d05270bf4", "parentComponentId": null }, { "bbox": { "h": 0.12, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "title", "text": "Based on surgeon color, we expect papers on the lack of correlation between OCS pump data versus actual organ viability and outcomes – which would only accelerate the customer exodus.", "attrs": null, "canon": { "kind": { "name": "Title", "slug": "title", "status": "active", "canonId": "019de52c-f7dd-76d9-b848-b1f12bd85cf4", "version": 1, "description": "Slide title or headline." }, "tool": null, "subkind": { "name": "Headline", "slug": "headline", "status": "active", "canonId": "019de52c-fae1-7463-9a7c-d60668eced0d", "version": 1, "description": null }, "framework": null }, "subkind": "headline", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:26:00.429+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "68c29191-e3ef-452c-a8a3-d996df4a46b9", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [], "arcBeats": [], "loops": [], "locked": true }, { "page": 288, "type": "tension", "title": "The slide uses a 'before-after' style comparison between a conceptual timeline and actual competitor hardware.", "function": "name_villain", "rawType": "villain_critique", "block": null, "metadata": { "slideType": "villain_critique", "slideTypeCanon": { "name": "Villain critique", "slug": "villain_critique", "status": "active", "canonId": "019de52d-10bc-7136-bf20-09de59d17447", "version": 1, "description": null }, "function": "name_villain", "functionCanon": { "name": "Name villain", "slug": "name_villain", "status": "active", "canonId": "019de52d-1746-70d6-bc58-5eeaf5865526", "version": 1, "description": null }, "density": "balanced", "densityScore": 46, "componentCount": 6, "textChars": 1104, "nDataPoints": 6, "notes": "The slide uses a 'before-after' style comparison between a conceptual timeline and actual competitor hardware.", "elementsJson": [ "paragraph", "timeline_visual", "screenshot", "photo", "footnote" ], "confidence": 0.95, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 21:25:59.589+00", "seconds": 3.218, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/288", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-288", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "TransMedics has – and will never have – any opportunity in kidney as 1) only 40% of kidneys are pumped due to cost, despite the pumps being around for decades; 2) LifePort has 85% market share with its kidney pump; and 3) their pump is a third of TransMedics OCS cost at $30K.", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:21+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a988-da21ebb85011", "parentComponentId": null }, { "bbox": { "h": 0.4, "w": 0.5, "x": 0.45, "y": 0.45 }, "kind": "image", "text": "LifePort Kidney Transporter", "attrs": null, "canon": { "kind": { "name": "Image", "slug": "image", "status": "active", "canonId": "019de52c-f978-701f-a720-51d029d769e7", "version": 1, "description": "Photo, illustration, screenshot or icon." }, "tool": null, "subkind": { "name": "Photo", "slug": "photo", "status": "active", "canonId": "019de52c-fd37-757f-b4a8-ca26d4888875", "version": 1, "description": null }, "framework": null }, "subkind": "photo", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:25:59.589+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "8dd54e46-4309-4705-8709-786850f7777c", "parentComponentId": null }, { "bbox": { "h": 0.4, "w": 0.4, "x": 0.05, "y": 0.45 }, "kind": "image", "text": "TMDX OCS Kidney Timeline - Gear 3", "attrs": null, "canon": { "kind": { "name": "Image", "slug": "image", "status": "active", "canonId": "019de52c-f978-701f-a720-51d029d769e7", "version": 1, "description": "Photo, illustration, screenshot or icon." }, "tool": null, "subkind": { "name": "Screenshot", "slug": "screenshot", "status": "active", "canonId": "019de52c-fd87-7509-8391-3d79fb339379", "version": 1, "description": null }, "framework": null }, "subkind": "screenshot", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:25:59.589+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "e91ecab1-6538-45a6-838b-79882bf75bc3", "parentComponentId": null }, { "bbox": { "h": 0.25, "w": 0.9, "x": 0.05, "y": 0.2 }, "kind": "paragraph", "text": "as kidneys are by far the largest transplant market with 25K transplants per year in the US, versus only 10K livers, 4k hearts, and 3K lungs, per OPTN data. It purports to have a kidney product in development - for 2029 launch, amusingly - but showed nothing but a conceptual vaporware slide during its recent investor day. TransMedics has – and will never have – any opportunity in kidney as 1) only 40% of kidneys are pumped due to cost, despite the pumps being around for decades; 2) LifePort has 85% market share with its kidney pump; and 3) their pump is a third of TransMedics OCS cost at $30K.", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:25:59.589+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "3c84ce31-3dc3-45db-b598-c7e550befc56", "parentComponentId": null }, { "bbox": { "h": 0.03, "w": 0.3, "x": 0.05, "y": 0.95 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:25:59.589+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "dd1c1186-02c8-4264-b22e-dd60cc706abe", "parentComponentId": null }, { "bbox": { "h": 0.15, "w": 0.9, "x": 0.05, "y": 0.05 }, "kind": "title", "text": "TransMedics lack of a kidney pump is a critical tell that undermines the OCS bull case as a multi-organ platform", "attrs": null, "canon": { "kind": { "name": "Title", "slug": "title", "status": "active", "canonId": "019de52c-f7dd-76d9-b848-b1f12bd85cf4", "version": 1, "description": "Slide title or headline." }, "tool": null, "subkind": { "name": "Headline", "slug": "headline", "status": "active", "canonId": "019de52c-fae1-7463-9a7c-d60668eced0d", "version": 1, "description": null }, "framework": null }, "subkind": "headline", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:25:59.589+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "83c5e983-9bd0-439e-aa9d-b9e0e9eeef44", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [ { "matchId": "c5190229-caad-44be-9345-e7b21de96275", "evidence": "The slide frames TransMedics as a failing entity ('vaporware') compared to the established competitor LifePort.", "framework": null, "confidence": 0.9, "extraction": { "at": "2026-05-02 21:25:59.589+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 288, "frameworkName": "antagonist-introduction" } ], "arcBeats": [], "loops": [], "locked": true }, { "page": 289, "type": "tension", "title": "The slide uses expert quotes to undermine the competitive moat of TransMedics by comparing it to existing, commoditized kidney perfusion technology.", "function": "name_villain", "rawType": "villain_critique", "block": null, "metadata": { "slideType": "villain_critique", "slideTypeCanon": { "name": "Villain critique", "slug": "villain_critique", "status": "active", "canonId": "019de52d-10bc-7136-bf20-09de59d17447", "version": 1, "description": null }, "function": "name_villain", "functionCanon": { "name": "Name villain", "slug": "name_villain", "status": "active", "canonId": "019de52d-1746-70d6-bc58-5eeaf5865526", "version": 1, "description": null }, "density": "overcrowded", "densityScore": 77, "componentCount": 8, "textChars": 3109, "nDataPoints": 4, "notes": "The slide uses expert quotes to undermine the competitive moat of TransMedics by comparing it to existing, commoditized kidney perfusion technology.", "elementsJson": [ "headline_text", "paragraph", "quote_block", "footnote" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 21:26:00.14+00", "seconds": 3.745, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/289", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-289", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "To date, TransMedics and XVIVO have no device even in trials for kidney that I know of.", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:23+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5374-767b-b3bb-865b396ea7c4", "parentComponentId": null }, { "bbox": { "h": 0.03, "w": 0.86, "x": 0.07, "y": 0.52 }, "kind": "paragraph", "text": "LifePort has 85% share of kidney pump market", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:26:00.14+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "6245a2d1-bfe7-4ef0-8f57-3c27615d7b4d", "parentComponentId": null }, { "bbox": { "h": 0.03, "w": 0.86, "x": 0.07, "y": 0.33 }, "kind": "paragraph", "text": "Kidney pumps used for 40 years but less than 40% pumped “for financial reasons”", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:26:00.14+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "d581d0e9-b4d7-49c0-bb86-9c9537eb189a", "parentComponentId": null }, { "bbox": { "h": 0.25, "w": 0.86, "x": 0.07, "y": 0.55 }, "kind": "quote", "text": "“Right now, the only people in that space, which is the largest, with their 20,000-25,000 kidneys a year, are the egg-shaped devices that have been around for four decades. The company that’s emerged as being the largest in terms of the market share is the one we use, when we have a kidney rigged from an older donor, somebody, say in their 60s or 70s, is the LifePort kidney device. Bridge to Life may have something, but right now, LifePort, of the kidneys that are pumped, which in the U.S. is probably about 30% of the kidneys total in the U.S. are pumped, 85% of that is under LifePort. To date, TransMedics and XVIVO have no device even in trials for kidney that I know of. They’ve just prototypes in the lab. Kidney is really easy to talk about. There is no other company out there other than LifePort. When we pump a kidney, it’s an extra $30,000 per case.” – Prominent surgeon, Director of leading West Coast academic transplant center", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:26:00.14+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "9098bd8a-cd22-410f-bafc-4a5fb1f65cfe", "parentComponentId": null }, { "bbox": { "h": 0.15, "w": 0.86, "x": 0.07, "y": 0.36 }, "kind": "quote", "text": "“For kidney, there’s actually been pumping technologies, portable perfusion devices that have been around for literally 40 years, and that’s a good example of a technology that’s similar to TransMedics. But despite the fact that kidney transporting technology has been around for 40 years, less than 40% of kidneys in the United States per year are pumped for financial reasons. All of these companies - XVIVO, LifePort - had to segue to liver transplantation...because those are the fields that there are tens of thousands of transplants as opposed to just a few thousand hearts and lungs per year.” – Prominent surgeon, Director of leading West Coast academic transplant center", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:26:00.14+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "ea8280ec-c357-4e03-a737-35b4f8d1f3ec", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "“For kidney, there’s actually been pumping technologies, portable perfusion devices that have been around for literally 40 years, and that’s a good example of a technology that’s similar to TransMedics. But despite the fact that kidney transporting technology has been around for 40 years, less than 40% of kidneys in the United States per year are pumped for financial reasons. All of these companies - XVIVO, LifePort - had to segue to liver transplantation...because those are the fields that there are tens of thousands of transplants as opposed to just a few thousand hearts and lungs per year.” — Prominent surgeon, Director of leading West Coast academic transplant center", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:23+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5374-767b-b3bb-888460910e5b", "parentComponentId": null }, { "bbox": { "h": 0.02, "w": 0.3, "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:26:00.14+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "636a29be-385e-442f-988a-9fef99dcc71e", "parentComponentId": null }, { "bbox": { "h": 0.22, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "title", "text": "Indicating the commodity nature of TransMedics OCS device, transplant surgeons indicated that kidney “portable perfusion pumps...have been around for literally 40 years” and are “a good example of technology that’s similar to TransMedics...but despite the fact that kidney transporting technology has been around for 40 years, less than 40% of kidneys are pumped...for financial reasons...TransMedics and XVIVO have no device even in trials....kidney is really easy to talk about....there is no other company out there other than LifePort.”", "attrs": null, "canon": { "kind": { "name": "Title", "slug": "title", "status": "active", "canonId": "019de52c-f7dd-76d9-b848-b1f12bd85cf4", "version": 1, "description": "Slide title or headline." }, "tool": null, "subkind": { "name": "Headline", "slug": "headline", "status": "active", "canonId": "019de52c-fae1-7463-9a7c-d60668eced0d", "version": 1, "description": null }, "framework": null }, "subkind": "headline", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:26:00.14+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "93854657-47db-4380-aa3f-aee292b6212a", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [], "arcBeats": [], "loops": [], "locked": true }, { "page": 290, "type": "tension", "title": "The slide uses a Q&A format to highlight the perceived lack of value proposition for the OCS Lung product.", "function": "expose_contradiction", "rawType": "expose_contradiction", "block": null, "metadata": { "slideType": "expose_contradiction", "slideTypeCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-124c-75aa-984a-0a3d0d8fc8df", "version": 1, "description": null }, "function": "expose_contradiction", "functionCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-171f-776f-887c-73edaff4cf9c", "version": 1, "description": null }, "density": "dense", "densityScore": 63, "componentCount": 7, "textChars": 2816, "nDataPoints": 0, "notes": "The slide uses a Q&A format to highlight the perceived lack of value proposition for the OCS Lung product.", "elementsJson": [ "paragraph", "quote_block", "footnote" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 21:26:00.217+00", "seconds": 3.641, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/290", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-290", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": { "h": 0.15, "w": 0.86, "x": 0.07, "y": 0.72 }, "kind": "callout", "text": "“Majority of cases” can be “safely preserved on ice”\nQ: “Does the device add any value versus the status quo in cold storage? It’s almost $100,000 for the device.”\nA: “It’s pretty expensive. I do believe that the majority of the cases can be safely preserved on ice. This is a method that was working pretty well. There’s a competitor who actually preserves organs on ice and then connects them to the circuit for assessment purposes only, not for the transfer.” - Former employee in senior roles including medical safety and clinical affairs", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": null, "subkind": { "name": "Primary callout", "slug": "primary", "status": "active", "canonId": "019de52c-fbd1-70eb-a9ce-8997f8674c1d", "version": 1, "description": null }, "framework": null }, "subkind": "primary", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:26:00.217+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "8185117a-3313-4cf1-aac6-0172e1a8473d", "parentComponentId": null }, { "bbox": { "h": 0.25, "w": 0.86, "x": 0.07, "y": 0.42 }, "kind": "callout", "text": "“Product doesn’t work” for lung\nA: “I think the worst-performing product is definitely the lung. I think internally, that organ is preserved on ice just as well, if not better, just because of the complexity of the physiology and anatomy of the lung.”\nQ: “You’re saying that the device doesn’t add any value for the lung?”\nA: “I don’t think it does, yeah. I think there are very isolated cases, maybe like a long-distance retrieval that lasts 11 hours, 12 hours, something from Hawaii to New York and such. But anything within six hours, I don’t think they really need that device for the lung.”\nQ: “The entire U.S. is less than six hours flight time.”\nA: “Exactly, that’s what I’m saying.” - Former employee in senior roles including medical safety and clinical affairs", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": null, "subkind": { "name": "Primary callout", "slug": "primary", "status": "active", "canonId": "019de52c-fbd1-70eb-a9ce-8997f8674c1d", "version": 1, "description": null }, "framework": null }, "subkind": "primary", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:26:00.217+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "bafe930b-7e07-49f0-8840-30ae50878fab", "parentComponentId": null }, { "bbox": null, "kind": "callout", "text": "the worst-performing product is definitely the lung...that organ is preserved on ice just as well, if not better, because of the complexity of the physiology and anatomy of the lung...it’s pretty expensive...the majority of the cases can be safely preserved on ice...this is a method that was working pretty well.", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:22+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a989-2893641b8860", "parentComponentId": null }, { "bbox": { "h": 0.25, "w": 0.86, "x": 0.07, "y": 0.12 }, "kind": "paragraph", "text": "We next turn to OCS Lung, which TransMedics began commercializing in late 2018 after receiving PMA approval, its first FDA-approved product and the one it has marketed the longest – making its failure an inconvenient fact for the bull case, as it remains a negligible percent of total sales. A former employee in senior medical/clinical affairs roles stated the product serves no purpose versus storing lungs on ice: “the worst-performing product is definitely the lung...that organ is preserved on ice just as well, if not better, because of the complexity of the physiology and anatomy of the lung...it’s pretty expensive...the majority of the cases can be safely preserved on ice...this is a method that was working pretty well.”", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:26:00.217+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "4009957b-b022-4706-ac31-cf2f999475c6", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "“the worst-performing product is definitely the lung...that organ is preserved on ice just as well, if not better, because of the complexity of the physiology and anatomy of the lung...it’s pretty expensive...the majority of the cases can be safely preserved on ice...this is a method that was working pretty well.” — Former employee in senior roles including medical safety and clinical affairs", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:22+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a989-2d9d0be4776f", "parentComponentId": null }, { "bbox": { "h": 0.02, "w": 0.3, "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:26:00.217+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "5e698038-7ac7-4c96-9663-0b2460ec9a1d", "parentComponentId": null }, { "bbox": { "h": 0.03, "w": 0.15, "x": 0.07, "y": 0.07 }, "kind": "title", "text": "OCS Lung", "attrs": null, "canon": { "kind": { "name": "Title", "slug": "title", "status": "active", "canonId": "019de52c-f7dd-76d9-b848-b1f12bd85cf4", "version": 1, "description": "Slide title or headline." }, "tool": null, "subkind": { "name": "Headline", "slug": "headline", "status": "active", "canonId": "019de52c-fae1-7463-9a7c-d60668eced0d", "version": 1, "description": null }, "framework": null }, "subkind": "headline", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:26:00.217+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "daadf1e4-ec46-4fce-aac3-9a4f8e2f1465", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [ { "matchId": "130a87cf-185a-41c2-a11d-c2a1cd704a80", "evidence": "The slide contrasts the company's commercialization of the product with internal expert testimony claiming it is ineffective.", "framework": null, "confidence": 0.9, "extraction": { "at": "2026-05-02 21:26:00.217+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 290, "frameworkName": "expose_contradiction" } ], "arcBeats": [], "loops": [], "locked": true }, { "page": 291, "type": "tension", "title": "The slide uses direct quotes from a surgeon to undermine the company's value proposition.", "function": "name_villain", "rawType": "villain_critique", "block": null, "metadata": { "slideType": "villain_critique", "slideTypeCanon": { "name": "Villain critique", "slug": "villain_critique", "status": "active", "canonId": "019de52d-10bc-7136-bf20-09de59d17447", "version": 1, "description": null }, "function": "name_villain", "functionCanon": { "name": "Name villain", "slug": "name_villain", "status": "active", "canonId": "019de52d-1746-70d6-bc58-5eeaf5865526", "version": 1, "description": null }, "density": "dense", "densityScore": 72, "componentCount": 8, "textChars": 3444, "nDataPoints": 0, "notes": "The slide uses direct quotes from a surgeon to undermine the company's value proposition.", "elementsJson": [ "paragraph", "quote_block" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 21:26:06.696+00", "seconds": 9.565, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/291", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-291", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": { "h": 0.02, "w": 0.35, "x": 0.07, "y": 0.81 }, "kind": "callout", "text": "Radically cheaper to use cold storage for lungs", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": null, "subkind": { "name": "Primary callout", "slug": "primary", "status": "active", "canonId": "019de52c-fbd1-70eb-a9ce-8997f8674c1d", "version": 1, "description": null }, "framework": null }, "subkind": "primary", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:26:06.696+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "3b1fcf5b-cdbb-48e5-b02a-c15283c0bf2a", "parentComponentId": null }, { "bbox": { "h": 0.02, "w": 0.35, "x": 0.07, "y": 0.51 }, "kind": "callout", "text": "“No one” using lung product anymore; total failure", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": null, "subkind": { "name": "Primary callout", "slug": "primary", "status": "active", "canonId": "019de52c-fbd1-70eb-a9ce-8997f8674c1d", "version": 1, "description": null }, "framework": null }, "subkind": "primary", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:26:06.696+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "add19aa2-319b-492c-b8b0-79f61117874a", "parentComponentId": null }, { "bbox": null, "kind": "callout", "text": "I do not see them having any market at all in lung anywhere in the United States or, for that matter, even worldwide compared to a much cheaper technology like 10-degrees Celsius storage.", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:22+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a989-5623bd7c1331", "parentComponentId": null }, { "bbox": { "h": 0.45, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "paragraph", "text": "A prominent cardiothoracic transplant surgeon who leads a large academic program stated the lung product is as an utter failure as “no one’s using it anymore in the US”; that the “really enthusiastic centers that were heavily involved in the trials…have stopped using it”; that “I don’t see them having any future in lung”; and that a variety of cheaper alternative devices, already available or in trials, are not only superior but “just much, much cheaper.” He stated that extensive research and clinical trials since the OCS Lung approval have shown that cold storage around 10 degrees Celsius – slightly above traditional static cold storage – provides superior benefits over TransMedics warm perfusion pump, undermining the entire premise of its – “I do not see them having any market at all in lung anywhere in the US or, for that matter, even worldwide compared to a much cheaper technology like 10-degrees Celsius storage.”", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:26:06.696+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "2283acfd-fb72-406e-8f1d-4bad2fe50431", "parentComponentId": null }, { "bbox": { "h": 0.25, "w": 0.86, "x": 0.07, "y": 0.54 }, "kind": "quote", "text": "Q: “Does their device add anything in lung versus cold storage or other methods to justify the cost?” A: “The short answer is no. The longer answer is that despite that being the first approved device for TransMedics of an organ type, almost no one’s using it anymore in the US. It’s being used maybe 100-120 times per year, and most of the centers that I know, including the really enthusiastic centers that were heavily involved in the trials and the trial design, have stopped using it, and I don’t see them having any future in lung. And the reason for that is not just because of XVIVO’s collaboration with Lung Bioengineering, but more importantly, two years ago, the University of Toronto published their 10-degree Celsius storage story, and so there’s a spinoff company called Traferox that’s Canadian-based in conjunction with the University of Toronto that is currently doing a multi-center, large, randomized trial in the U.S. for transporting lungs at 10 degrees instead of a regular ice chest to give it a little bit like Paragonix. The short answer is to your question is that I do not see them having any market at all in lung anywhere in the United States or, for that matter, even worldwide compared to a much cheaper technology like 10-degrees Celsius storage.” – Prominent surgeon, director of leading academic transplant center", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:26:06.696+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "16d3828b-f371-45ac-b8fd-6116cde950e1", "parentComponentId": null }, { "bbox": { "h": 0.12, "w": 0.86, "x": 0.07, "y": 0.83 }, "kind": "quote", "text": "“It’s just much cheaper. It’s much, much cheaper…the costs of the technology versus the reimbursement are so prohibitively expensive that if you can do something that only costs $5000 or $8000, which is probably where Traferox could come out, maybe even if you charged as much ridiculous charges as Paragonix does of $14,000 or $15,000 like they’re doing with their stupid device. The fact is it’s still much, much cheaper than $85,000, and the logistics are also more complicated. ” – Prominent surgeon, director of leading academic transplant center", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:26:06.696+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "59ca3740-f3c5-4aca-9927-45f6d11bb2e4", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "\"no one’s using it anymore in the US\"; \"really enthusiastic centers that were heavily involved in the trials...have stopped using it\"; \"I don’t see them having any future in lung\"; \"just much, much cheaper.\" — Prominent surgeon, director of leading academic transplant center", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:22+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a989-59f5849e4867", "parentComponentId": null }, { "bbox": { "h": 0.02, "w": 0.25, "x": 0.07, "y": 0.96 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:26:06.696+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "02c70d62-1bd7-4790-8d18-86c788c69f3e", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [], "arcBeats": [], "loops": [], "locked": true }, { "page": 292, "type": "tension", "title": "The slide uses highlighted text to emphasize key negative claims from a surgeon.", "function": "expose_contradiction", "rawType": "expose_contradiction", "block": null, "metadata": { "slideType": "expose_contradiction", "slideTypeCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-124c-75aa-984a-0a3d0d8fc8df", "version": 1, "description": null }, "function": "expose_contradiction", "functionCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-171f-776f-887c-73edaff4cf9c", "version": 1, "description": null }, "density": "overcrowded", "densityScore": 85, "componentCount": 10, "textChars": 3741, "nDataPoints": 0, "notes": "The slide uses highlighted text to emphasize key negative claims from a surgeon.", "elementsJson": [ "paragraph", "quote_block", "footnote" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 21:26:02.856+00", "seconds": 5.383, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/292", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-292", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "They initially got traction in lung. I think their peak year - and this is again where the company's dishonest. They won't tell you, but I can tell you what they did.", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:22+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a989-7d8ef3710535", "parentComponentId": null }, { "bbox": { "h": 0.03, "w": 0.86, "x": 0.07, "y": 0.51 }, "kind": "paragraph", "text": "Allegedly trying to hide failure in lung; “have not see a pair of lungs rigged” in “over a year”", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:26:02.856+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "1df3e793-93b6-4d7a-a68c-981a96000442", "parentComponentId": null }, { "bbox": { "h": 0.03, "w": 0.86, "x": 0.07, "y": 0.27 }, "kind": "paragraph", "text": "Initial traction only due to special offer; killed off by XVIVO and cold storage", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:26:02.856+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "5e0510ba-49e3-4025-9815-986d04bfd6ab", "parentComponentId": null }, { "bbox": { "h": 0.03, "w": 0.86, "x": 0.07, "y": 0.72 }, "kind": "paragraph", "text": "Lung business has disappeared, Paragonix has taken share in lung", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:26:02.856+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "f5e89147-9607-4a93-a3b5-ab0ceaf62db7", "parentComponentId": null }, { "bbox": { "h": 0.15, "w": 0.86, "x": 0.07, "y": 0.76 }, "kind": "quote", "text": "A: “Just be aware that TransMedics’ competition is with 10 degrees, with XVIVO through Lung Bioengineering as its collaborator, and then Paragonix is eroding some of the market for TransMedics because I’ve seen actually more lungs put on the Paragonix device; even if I think the Paragonix device is a waste of money for lung, they are definitely putting lungs on that device that in 2022 would have been put on the TransMedics device. Just for completeness, I just wanted to make sure you know that Paragonix does have a growing business in lung.” Q: “But the main takeaway is their lung business is gone.” A: “At least in the U.S., lung is only going to be 100 cases a year at best, is my guess.”", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:26:02.856+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "11bd3688-c7ba-4022-b07e-dbe8d1604778", "parentComponentId": null }, { "bbox": { "h": 0.15, "w": 0.86, "x": 0.07, "y": 0.55 }, "kind": "quote", "text": "My understanding is that, and you can get this directly from the company if they don’t smoke-and-mirror you with total sales and revenue but the number of disposable kits per organ sold year-to-year or quarter-to-quarter...they know exactly how many lung kits they’re selling. My guess would be without having actual proof, but based on everybody that I know in the field, my guess would be that you’d see that their peak year for lung usage was in 2022, it plummeted in 2023 and 2024. I personally have not seen a pair of lungs rigged on a TransMedics device in over a year.", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:26:02.856+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "3fab274e-25e1-43f8-97ac-50452e5a774a", "parentComponentId": null }, { "bbox": { "h": 0.18, "w": 0.86, "x": 0.07, "y": 0.31 }, "kind": "quote", "text": "They initially got traction in lung. I think their peak year - and this is again where the company’s dishonest. They won’t tell you, but I can tell you what they did. In 2022, post-FDA approval, to gin up interest, they had a deal, which they did with liver, too, I believe. They would not charge the transplant center if the organ was rejected while it was on the device. You only paid for lungs that were used. And then when 2022 ended, in calendar year 2023, you paid whether you took the organ or not. And a lot of transplant centers got really pissed with that. In fact, that’s the reason why there was a lot of enthusiasm in 2022, which I believe was their peak year for lung usage in the U.S. It plummeted for two reasons. One, you now had to pay for an organ whether you used it or not. Two, enthusiasm for XVIVO’s device with Lung Bioengineering. Number three, which really put the nail on the coffin, was the 10-degree Celsius storage story.", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:26:02.856+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "50351fd1-047e-41dc-924b-9ebbde056060", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "“They initially got traction in lung. I think their peak year - and this is again where the company's dishonest... It plummeted for two reasons. One, you now had to pay for an organ whether you used it or not. Two, enthusiasm for XVIVO's device with Lung Bioengineering. Number three, which really put the nail on the coffin, was the 10-degree Celsius storage story.” — Prominent surgeon, director of leading academic transplant center", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:22+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a989-808deeca67b2", "parentComponentId": null }, { "bbox": { "h": 0.02, "w": 0.3, "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:26:02.856+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "1fac6456-1037-4363-80c1-8551a75e9baf", "parentComponentId": null }, { "bbox": { "h": 0.18, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "title", "text": "The cardiothoracic surgeon indicated that the only reason OCS Lung even got any initial traction was due to a promotion and then plummeted after a bait-and-switch – “this is again where the company’s dishonest”; “I personally have not seen a pair of lungs rigged on a TransMedics device in over a year”; and indicated a fatal blow to its chances not just from 10-degree Celsius, but by “enthusiasm for XVIVO’s device with Lung Bioengineering” and Paragonix which has also taken TransMedics share: “I just wanted to make sure you know that Paragonix does have a growing business in lung,” versus TMDX which has flatlined.", "attrs": null, "canon": { "kind": { "name": "Title", "slug": "title", "status": "active", "canonId": "019de52c-f7dd-76d9-b848-b1f12bd85cf4", "version": 1, "description": "Slide title or headline." }, "tool": null, "subkind": { "name": "Headline", "slug": "headline", "status": "active", "canonId": "019de52c-fae1-7463-9a7c-d60668eced0d", "version": 1, "description": null }, "framework": null }, "subkind": "headline", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:26:02.856+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "d974abd7-12ba-4859-a582-132fecefbe75", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [], "arcBeats": [], "loops": [], "locked": true }, { "page": 293, "type": "tension", "title": "The slide uses expert testimonials to argue that the TransMedics device is 'fatally flawed' because it does not allow for functional assessment under load.", "function": "name_villain", "rawType": "villain_critique", "block": null, "metadata": { "slideType": "villain_critique", "slideTypeCanon": { "name": "Villain critique", "slug": "villain_critique", "status": "active", "canonId": "019de52d-10bc-7136-bf20-09de59d17447", "version": 1, "description": null }, "function": "name_villain", "functionCanon": { "name": "Name villain", "slug": "name_villain", "status": "active", "canonId": "019de52d-1746-70d6-bc58-5eeaf5865526", "version": 1, "description": null }, "density": "overcrowded", "densityScore": 87, "componentCount": 10, "textChars": 2706, "nDataPoints": 2, "notes": "The slide uses expert testimonials to argue that the TransMedics device is 'fatally flawed' because it does not allow for functional assessment under load.", "elementsJson": [ "paragraph", "quote_block" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 21:26:00.852+00", "seconds": 3.375, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/293", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-293", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": { "h": 0.03, "w": 0.86, "x": 0.07, "y": 0.72 }, "kind": "callout", "text": "30-40% of heart programs already moved to NRP; can assess the heart better with NRP", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": null, "subkind": { "name": "Primary callout", "slug": "primary", "status": "active", "canonId": "019de52c-fbd1-70eb-a9ce-8997f8674c1d", "version": 1, "description": null }, "framework": null }, "subkind": "primary", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:26:00.852+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "49f1da8d-f1ea-495e-9ac9-52125f9bb687", "parentComponentId": null }, { "bbox": { "h": 0.03, "w": 0.86, "x": 0.07, "y": 0.51 }, "kind": "callout", "text": "Device is fatally flawed for heart as no pressure; NRP better", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": null, "subkind": { "name": "Primary callout", "slug": "primary", "status": "active", "canonId": "019de52c-fbd1-70eb-a9ce-8997f8674c1d", "version": 1, "description": null }, "framework": null }, "subkind": "primary", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:26:00.852+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "95d09612-c364-4c57-8698-7a8d74723000", "parentComponentId": null }, { "bbox": null, "kind": "callout", "text": "The problem, compared to what you can do with NRP or other technologies, is that the heart on the TransMedics device is beating but it's empty...it's not doing any work...it's not supporting circulation...it's not generating a pressure.", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:23+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5374-767b-b3bb-b40b7bbd7742", "parentComponentId": null }, { "bbox": { "h": 0.08, "w": 0.86, "x": 0.07, "y": 0.38 }, "kind": "paragraph", "text": "30-40% of heart programs in the US are now using NRP – you can assess the heart function completely...you're doing it in three to four minutes...you can assess all the normal physiologic parameters: is the heart beating again in the patient.", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:26:00.852+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "57deafdd-11b0-43a5-8c54-b0131e7e935d", "parentComponentId": null }, { "bbox": { "h": 0.15, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "paragraph", "text": "After kidney and lung, we now discuss the heart product. Lung failed as cold storage is provably superior to warm perfusion – TransMedics entire premise was fatally flawed. Heart usage is in freefall for similar reasons: the pump is inferior to NRP in assessing heart function pre-transplant.", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:26:00.852+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "5ddf487a-139e-49e4-a66b-b4bbbe2966e6", "parentComponentId": null }, { "bbox": { "h": 0.12, "w": 0.86, "x": 0.07, "y": 0.55 }, "kind": "quote", "text": "The initial trials that TransMedics did were in conjunction with the guys from Cambridge in the UK... The problem, compared to what you can do with NRP or other technologies, is that the heart on the TransMedics device is beating, but it's empty.", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:26:00.852+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "574f9363-4791-4825-8192-7e17e8ad4346", "parentComponentId": null }, { "bbox": { "h": 0.15, "w": 0.86, "x": 0.07, "y": 0.22 }, "kind": "quote", "text": "the problem, compared to what you can do with NRP or other technologies, is that the heart on the TransMedics device is beating but it's empty...it's not doing any work...it's not supporting circulation...it's not generating a pressure...", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:26:00.852+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "740a19d2-75aa-4530-9d98-d9fcab0c66a5", "parentComponentId": null }, { "bbox": { "h": 0.15, "w": 0.86, "x": 0.07, "y": 0.76 }, "kind": "quote", "text": "My center is doing the same protocol that probably 30-40% of heart programs in the U.S. are doing now is we're using NRP... you can assess the heart function completely... you can assess all the normal physiologic parameters.", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:26:00.852+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "d69c7dd1-1541-43c5-bc51-cec23db7ed9f", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "\"The problem, compared to what you can do with NRP or other technologies, is that the heart on the TransMedics device is beating, but it's empty. It's not doing any work. It's not supporting circulation. It's not generating a pressure. So, you're guessing at that part, which is beating on the device based on the lactic acid level dropping, that it will function well enough that your recipient patient doesn't end up on ECMO or an Impella or on something else.\" — Prominent surgeon, director of leading academic transplant center; \"30-40% of heart programs in the U.S. are doing now is we're using NRP, normothermic regional perfusion... you can assess the heart function completely because you're putting the donor who's arrested, you're opening their chest and cannulating them and going on bypass rapidly, but you're doing it in three to four minutes... and you can assess all the normal physiologic parameters: is the heart beating again in the patient.\" — Prominent surgeon, director of leading academic transplant center", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:23+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5374-767b-b3bb-b815a8914d18", "parentComponentId": null }, { "bbox": { "h": 0.02, "w": 0.3, "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:26:00.852+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "2312c09e-9e5d-4ffc-a172-05d195a30485", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [], "arcBeats": [], "loops": [], "locked": true }, { "page": 294, "type": "resolution", "title": "The slide uses direct quotes from surgeons to validate the market share shift thesis.", "function": "summarize", "rawType": "key_takeaways", "block": null, "metadata": { "slideType": "key_takeaways", "slideTypeCanon": { "name": "Key takeaways", "slug": "key_takeaways", "status": "active", "canonId": "019de52d-06e7-7674-a891-9f7de3b11b6d", "version": 1, "description": null }, "function": "summarize", "functionCanon": { "name": "Summarize", "slug": "summarize", "status": "active", "canonId": "019de52d-1541-704f-b86f-bf7b75056373", "version": 1, "description": null }, "density": "overcrowded", "densityScore": 80, "componentCount": 10, "textChars": 1460, "nDataPoints": 6, "notes": "The slide uses direct quotes from surgeons to validate the market share shift thesis.", "elementsJson": [ "paragraph", "quote_block", "footnote" ], "confidence": 0.95, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 21:26:00.864+00", "seconds": 3.199, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/294", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-294", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": { "h": 0.03, "w": 0.86, "x": 0.07, "y": 0.66 }, "kind": "callout", "text": "XVIVO heart system will take half of TransMedics remaining heart volume; but both being decimated by NRP", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": null, "subkind": { "name": "Primary callout", "slug": "primary", "status": "active", "canonId": "019de52c-fbd1-70eb-a9ce-8997f8674c1d", "version": 1, "description": null }, "framework": null }, "subkind": "primary", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:26:00.864+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "a57c3b53-e37f-4289-b5d1-68d2edc545c2", "parentComponentId": null }, { "bbox": { "h": 0.03, "w": 0.86, "x": 0.07, "y": 0.46 }, "kind": "callout", "text": "NRP rapidly eroding TransMedics market share in DCD hearts", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": null, "subkind": { "name": "Primary callout", "slug": "primary", "status": "active", "canonId": "019de52c-fbd1-70eb-a9ce-8997f8674c1d", "version": 1, "description": null }, "framework": null }, "subkind": "primary", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:26:00.864+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "c376a98f-f084-4ae4-9048-8fd863034a5b", "parentComponentId": null }, { "bbox": null, "kind": "callout", "text": "TransMedics had 100% of the DCD heart market a mere 2 to 3 years ago. That share dropped to 60-70% vs. 30% NRP over the last year or two, but NRP has now flipped to pole position with 50-60% share at TransMedics expense.", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:22+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a989-97b6cdac23e7", "parentComponentId": null }, { "bbox": null, "kind": "metric", "text": "market share: 50-60%", "attrs": null, "canon": { "kind": { "name": "Metric", "slug": "metric", "status": "active", "canonId": "019de52c-f923-73bf-8081-d0b1a8c5264d", "version": 1, "description": "Big-number or KPI value." }, "tool": { "name": "Quantification", "slug": "quantification", "status": "active", "bestFor": null, "canonId": "019dd9e1-47ab-72ce-a079-aab1f5299e88", "version": 1, "bodyDocId": null, "description": "Translating a claim into numbers, charts, or tables.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": "primary", "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:22+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a989-9e73b48f3ce9", "parentComponentId": null }, { "bbox": { "h": 0.25, "w": 0.86, "x": 0.07, "y": 0.19 }, "kind": "paragraph", "text": "TransMedics had 100% of the DCD heart market a mere 2 to 3 years ago. That share dropped to 60-70% vs. 30% NRP over the last year or two, but NRP has now flipped to pole position with 50-60% share at TransMedics expense...", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:26:00.864+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "7ac08f86-b022-43d0-9e9a-432d04c68b6a", "parentComponentId": null }, { "bbox": { "h": 0.15, "w": 0.86, "x": 0.07, "y": 0.49 }, "kind": "quote", "text": "\"TransMedics' device first started getting used in the US... last year, in 2023, there were over 600 DCD hearts done, of which probably about 60-70% were on TransMedics and 30% were NRP...\"", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:26:00.864+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "4bc76c9d-6dd5-4d4a-9dc9-f51b82f5247c", "parentComponentId": null }, { "bbox": { "h": 0.25, "w": 0.86, "x": 0.07, "y": 0.69 }, "kind": "quote", "text": "\"In addition to NRP you should be aware that XVIVO has finished their Australian trials... Both XVIVO and TransMedics are going to have serious competition from NRP...\"", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:26:00.864+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "ab99fe44-e3b8-4819-802b-b0baf95af345", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "\"both XVIVO and TransMedics are going to have serious competition from NRP...I think at least 50% of heart centers will feel very comfortable doing NRP...they're going to split that remaining market right down the middle.\" — Prominent surgeon, director of leading academic transplant center", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:22+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a989-99554ebc0018", "parentComponentId": null }, { "bbox": { "h": 0.03, "w": 0.3, "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:26:00.864+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "cfcc49df-0ce3-4f89-8b28-b0c93321af71", "parentComponentId": null }, { "bbox": { "h": 0.12, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "title", "text": "Cardiothoracic transplant surgeons indicated that NRP has rapidly eroded TransMedics usage in DCD hearts in the past 12 to 24 months.", "attrs": null, "canon": { "kind": { "name": "Title", "slug": "title", "status": "active", "canonId": "019de52c-f7dd-76d9-b848-b1f12bd85cf4", "version": 1, "description": "Slide title or headline." }, "tool": null, "subkind": { "name": "Headline", "slug": "headline", "status": "active", "canonId": "019de52c-fae1-7463-9a7c-d60668eced0d", "version": 1, "description": null }, "framework": null }, "subkind": "headline", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:26:00.864+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "4c86ec1d-22dc-4b38-95b3-513b32aa12b6", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [], "arcBeats": [], "loops": [], "locked": true }, { "page": 295, "type": "tension", "title": "The slide uses a direct quote from a surgeon to undermine the credibility and clinical utility of the TransMedics OCS device.", "function": "expose_contradiction", "rawType": "villain_critique", "block": null, "metadata": { "slideType": "villain_critique", "slideTypeCanon": { "name": "Villain critique", "slug": "villain_critique", "status": "active", "canonId": "019de52d-10bc-7136-bf20-09de59d17447", "version": 1, "description": null }, "function": "expose_contradiction", "functionCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-171f-776f-887c-73edaff4cf9c", "version": 1, "description": null }, "density": "dense", "densityScore": 57, "componentCount": 6, "textChars": 2314, "nDataPoints": 2, "notes": "The slide uses a direct quote from a surgeon to undermine the credibility and clinical utility of the TransMedics OCS device.", "elementsJson": [ "paragraph", "quote_block", "footnote" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 21:26:05.371+00", "seconds": 7.46, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/295", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-295", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "there are concerns with pumping a heart for a long period...a pump is not a benign thing...if you go back and read the comments on the FDA panel, there’s data from TransMedics studies that suggest myocardial edema...whether the data will ultimately support this is still being hotly debated at transplant meetings...there still remains skepticism about pumping organs...and increasing the ischemic time...the data that surrounds OCS, does the patient really benefit, and is there truly no hard done to that organ?", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:22+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a989-b22a3b7f4f7a", "parentComponentId": null }, { "bbox": { "h": 0.45, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "paragraph", "text": "A cardiac surgeon at a major Midwest center – who was on the FDA panel that voted to approve TransMedics device – now barely uses the heart pump, in ~6 out of 60 total transplants per year. He stated the pump is controversial and still “hotly debated” years after FDA approval, with no proven benefit for lung or heart, and that it may in fact injure the heart – “there are concerns with pumping a heart for a long period...a pump is not a benign thing...if you go back and read the comments on the FDA panel, there’s data from TransMedics studies that suggest myocardial edema...whether the data will ultimately support this is still being hotly debated at transplant meetings...there still remains skepticism about pumping organs...and increasing the ischemic time...the data that surrounds OCS, does the patient really benefit, and is there truly no hard done to that organ?”", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:26:05.371+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "4c96c486-cbc3-411b-a77e-1b210fa1d339", "parentComponentId": null }, { "bbox": { "h": 0.25, "w": 0.86, "x": 0.07, "y": 0.67 }, "kind": "quote", "text": "Likely harm and no proven benefit from TransMedics pump for heart or lung. Lung is marginal, whether pumping the lung is a good thing. There are concerns with pumping a heart for a long period of time. A pump is not a benign thing.", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:26:05.371+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "7a0ae5d9-63f8-4e8d-9c2e-faca180950bc", "parentComponentId": null }, { "bbox": { "h": 0.15, "w": 0.86, "x": 0.07, "y": 0.51 }, "kind": "quote", "text": "Surgeon on FDA panel that approved heart device barely uses it anymore. I am a cardiac surgeon. Our program does about 60 heart transplants a year... We use TransMedics in 10-12% of our cases a year.", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:26:05.371+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "e7e77ad4-8709-409b-b9df-9787de89b0ed", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "\"I am a cardiac surgeon. Our program does about 60 heart transplants a year. We do not do lung transplants. We do Impeller liver transplants; I’m not involved in those. We use TransMedics in 10-12% of our cases a year. For disclosure, I was on the FDA panel that voted to approve TransMedics, so I’m very familiar with that product. We began to use it about two years ago.\" — Cardiac transplant surgeon at a major Midwest academic center", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:22+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a989-b460f4d252c2", "parentComponentId": null }, { "bbox": { "h": 0.03, "w": 0.3, "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:26:05.371+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "2739bf8c-2174-4f4a-884c-5f88d2ba7338", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [ { "matchId": "1c68b054-92b4-49f1-9902-03643c000331", "evidence": "Uses a cardiac surgeon's credentials and FDA panel experience to validate the critique.", "framework": null, "confidence": 0.9, "extraction": { "at": "2026-05-02 21:26:05.371+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 295, "frameworkName": "authority-citation" } ], "arcBeats": [], "loops": [], "locked": true }, { "page": 296, "type": "tension", "title": "The slide uses a direct quote from an expert to undermine the value proposition of the TransMedics device.", "function": "expose_contradiction", "rawType": "quote_slide", "block": null, "metadata": { "slideType": "quote_slide", "slideTypeCanon": { "name": "Quote slide", "slug": "quote_slide", "status": "active", "canonId": "019de52d-098e-7555-a9fd-4f0af7e80bc2", "version": 1, "description": null }, "function": "expose_contradiction", "functionCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-171f-776f-887c-73edaff4cf9c", "version": 1, "description": null }, "density": "dense", "densityScore": 54, "componentCount": 6, "textChars": 2805, "nDataPoints": 0, "notes": "The slide uses a direct quote from an expert to undermine the value proposition of the TransMedics device.", "elementsJson": [ "paragraph", "quote_block", "footnote" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 21:26:05.181+00", "seconds": 6.773, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/296", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-296", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "There’s no way to assess a heart on the device; NRP is only method", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:24+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5374-767b-b3bc-b96d6172a0d3", "parentComponentId": null }, { "bbox": { "h": 0.35, "w": 0.86, "x": 0.07, "y": 0.55 }, "kind": "quote", "text": "At the end of the day, the device is a preservation machine. There are limitations in terms of the actual assessment of the heart on that device, that is not perfect. You watch it beat in the box. There are physiological reasons why it’s not the most robust test of organ quality and then lactate trends, not necessarily a marker that your organ is good or bad...there’s no way to assess it...the way your heart works and how we assess functionality is based on the ability to pump against resistance and load. And because you are in a solo, free-standing system with a TransMedics device, there is no resistance that it’s pumping against. If you resuscitate with NRP, which is normothermic regional perfusion, within the body of the donor, the resistance of that donor, blood vessels, etc., is put on the heart, and you can actually have a clear assessment of its functionality. That’s missing on the TransMedics’ device: true functional assessment of the organ. If it looks good on the machine, will it look good once you put it in and restart it and it’s not as strong?... There’s no alternative other than NRP, really.", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:26:05.181+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "a9d0a0b8-6f30-405b-a44a-1b55d4969494", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "“At the end of the day, the device is a preservation machine. There are limitations in terms of the actual assessment of the heart on that device, that is not perfect. You watch it beat in the box. There are physiological reasons why it’s not the most robust test of organ quality and then lactate trends, not necessarily a marker that your organ is good or bad...there’s no way to assess it...the way your heart works and how we assess functionality is based on the ability to pump against resistance and load. And because you are in a solo, free-standing system with a TransMedics device, there is no resistance that it’s pumping against. If you resuscitate with NRP, which is normothermic regional perfusion, within the body of the donor, the resistance of that donor, blood vessels, etc., is put on the heart, and you can actually have a clear assessment of its functionality. That’s missing on the TransMedics’ device: true functional assessment of the organ. If it looks good on the machine, will it look good once you put it in and restart it and it’s not as strong?... There’s no alternative other than NRP, really.” — Transplant cardiologist at a major Ivy League academic center", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:24+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5374-767b-b3bc-bf489d8a91d9", "parentComponentId": null }, { "bbox": { "h": 0.02, "w": 0.3, "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:26:05.181+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "5ea5219b-c9f8-44ae-bcac-4a5c834971dd", "parentComponentId": null }, { "bbox": { "h": 0.03, "w": 0.45, "x": 0.07, "y": 0.51 }, "kind": "title", "text": "No way to assess a heart on the device; NRP is only method", "attrs": null, "canon": { "kind": { "name": "Title", "slug": "title", "status": "active", "canonId": "019de52c-f7dd-76d9-b848-b1f12bd85cf4", "version": 1, "description": "Slide title or headline." }, "tool": null, "subkind": { "name": "Action title", "slug": "action-title", "status": "active", "canonId": "019de52c-fb31-734c-a0f5-a3935b73135d", "version": 1, "description": null }, "framework": null }, "subkind": "action-title", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:26:05.181+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "2a41bd29-652b-43b0-9ad4-7ff71b942901", "parentComponentId": null }, { "bbox": { "h": 0.35, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "title", "text": "A transplant cardiologist at a leading Ivy League center detailed the same concerns as Vanderbilt regarding an inability to properly assess a heart’s viability while on pump and its lack of predictive value – the entire point of the device, in contrast to NRP which he stated is the only way for a robust evaluation", "attrs": null, "canon": { "kind": { "name": "Title", "slug": "title", "status": "active", "canonId": "019de52c-f7dd-76d9-b848-b1f12bd85cf4", "version": 1, "description": "Slide title or headline." }, "tool": null, "subkind": { "name": "Headline", "slug": "headline", "status": "active", "canonId": "019de52c-fae1-7463-9a7c-d60668eced0d", "version": 1, "description": null }, "framework": null }, "subkind": "headline", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:26:05.181+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "a99105f1-d382-46b7-8fbb-235fccc8b01c", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [], "arcBeats": [], "loops": [], "locked": true }, { "page": 297, "type": "tension", "title": "The slide uses a quote-heavy structure to undermine the investment thesis for TransMedics (TMDX).", "function": "name_villain", "rawType": "villain_critique", "block": null, "metadata": { "slideType": "villain_critique", "slideTypeCanon": { "name": "Villain critique", "slug": "villain_critique", "status": "active", "canonId": "019de52d-10bc-7136-bf20-09de59d17447", "version": 1, "description": null }, "function": "name_villain", "functionCanon": { "name": "Name villain", "slug": "name_villain", "status": "active", "canonId": "019de52d-1746-70d6-bc58-5eeaf5865526", "version": 1, "description": null }, "density": "balanced", "densityScore": 46, "componentCount": 5, "textChars": 2074, "nDataPoints": 0, "notes": "The slide uses a quote-heavy structure to undermine the investment thesis for TransMedics (TMDX).", "elementsJson": [ "paragraph", "quote_block", "footnote" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 21:26:01.256+00", "seconds": 2.843, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/297", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-297", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "TransMedics has no value proposition vs. coolers and NRP.", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:22+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5373-719d-a989-c945d0ec75ef", "parentComponentId": null }, { "bbox": { "h": 0.38, "w": 0.86, "x": 0.07, "y": 0.52 }, "kind": "quote", "text": "Cooler systems for long distance use have less injuries to organ. We use them predominantly for DCD because for DBD, it's pretty rare for us to resort to using OCS. For longer distance or marginal grafts, we use other cooler systems that are really coming around, which we've found have less re-perfusion injuries and things like that post-transplant. So, our preference these days for any of these DCD hearts is to really prioritize NRP unless we're absolutely in a pinch and don't have the staffing bandwidth to procure an organ. For both DBD and DCD, and NRP, we've been trying to prioritize using these coolers that keep the heart closer to 8-10 degrees or so. There are a couple of commercially available ones, for example, Paragonix. One we use mostly is one that's repurposed from an internal cooler that our lung surgeons use to keep the heart around 10 degrees. And then we're actively involved in a clinical trial with XVIVO, which is another carrier that keeps the heart at roughly 10 degrees Celsius or so...even for long distance using 8 or 10-degree coolers is the preference. We've traveled as far as Alaska to procure hearts and haven't had any issues.", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:26:01.256+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "4eb0cf45-ec3a-4ec9-8e65-77aaa03c9f9f", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "“For longer distance of marginal grafts, we use other cooler systems that are really coming around, which we’ve found have less re-perfusion injuries...post-transplant.”; “for both DBD and DCD, we’ve been trying to prioritize using these coolers that keep the heart closer to 8-10 degrees or so”; “even for long distance using 8 or 10-degree coolers is the preference...we’ve traveled as far as Alaska to procure hearts and haven’t had any issue.” — Transplant cardiologist at one of the top centers in the US/world", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:22+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5374-767b-b3bb-4a50bd1c9f7e", "parentComponentId": null }, { "bbox": { "h": 0.02, "w": 0.25, "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:26:01.256+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "823b0fd0-29e9-4e1c-8a9f-9017313ea5ff", "parentComponentId": null }, { "bbox": { "h": 0.25, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "title", "text": "Vanderbilt stated that cheap, improved cooler systems they've simply repurposed internally are safer for hearts than warm perfusion pumps – devastating color for the TransMedics bull case, given Vanderbilt's gigantic transplant volume and access to every worthwhile device trial", "attrs": null, "canon": { "kind": { "name": "Title", "slug": "title", "status": "active", "canonId": "019de52c-f7dd-76d9-b848-b1f12bd85cf4", "version": 1, "description": "Slide title or headline." }, "tool": null, "subkind": { "name": "Headline", "slug": "headline", "status": "active", "canonId": "019de52c-fae1-7463-9a7c-d60668eced0d", "version": 1, "description": null }, "framework": null }, "subkind": "headline", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:26:01.256+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "ace04b91-5f96-4d75-aad7-a6613661f882", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [], "arcBeats": [], "loops": [], "locked": true }, { "page": 298, "type": "tension", "title": "The slide uses a Q&A transcript format to highlight negative expert sentiment.", "function": "expose_contradiction", "rawType": "villain_critique", "block": null, "metadata": { "slideType": "villain_critique", "slideTypeCanon": { "name": "Villain critique", "slug": "villain_critique", "status": "active", "canonId": "019de52d-10bc-7136-bf20-09de59d17447", "version": 1, "description": null }, "function": "expose_contradiction", "functionCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-171f-776f-887c-73edaff4cf9c", "version": 1, "description": null }, "density": "dense", "densityScore": 53, "componentCount": 6, "textChars": 2430, "nDataPoints": 0, "notes": "The slide uses a Q&A transcript format to highlight negative expert sentiment.", "elementsJson": [ "paragraph", "quote_block", "footnote" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 21:26:02.349+00", "seconds": 3.409, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/298", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-298", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "Vanderbilt indicated that TransMedics “absolutely” has no value proposition, with an exodus from the device among the top centers and those who participated in its trials", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:23+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5374-767b-b3bc-6d76e040d2a0", "parentComponentId": null }, { "bbox": { "h": 0.45, "w": 0.86, "x": 0.07, "y": 0.48 }, "kind": "paragraph", "text": "Q: “I would expect that 80% to 90% of the volume has to be the high-volume major centers of excellence, no?”\nA: “They enrolled some of the highest-volume transplant centers in their clinical trial and these were the main ones that were using them until the last couple of years where amongst our group of folks that we talk to across the country who are other high-volume transplant centers as well, there’s been a steady decrease in utilization of TransMedics.”\nQ: “So, you talked to other transplant centers, heart transplant centers, and they don’t use it for the same reasons you do?”\nA: “It’s gotten to the point that the folks that we speak with typically resort to it if there are issues with not having bandwidth, etc. But because so many centers are actively involved in research, whether it’s Paragonix or XVIVO, whatever it may be, or these other competing coolers that have really come out over the last couple of years, there’s less of an incentive to use the OCS for long-distance hearts because we can just use these instead. So, it’s really coming to do I have a certain bandwidth?”\nQ: “So, you can just use what instead?”\nA: “Coolers, these things that keep the heart at a different temperature than the typical preservation method.”\nQ: “So, you’re saying really has no value proposition.”\nA: “Absolutely. Its usage steadily has been declining amongst the high-volume heart transplant centers, and I don’t know how many of the low-volume ones are using them.” -Transplant cardiologist at one of the top centers in the US/world", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:26:02.349+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "a8423675-9fc5-474e-a708-52d4b3b87bf7", "parentComponentId": null }, { "bbox": { "h": 0.03, "w": 0.86, "x": 0.07, "y": 0.45 }, "kind": "paragraph", "text": "No value proposition; usage has tanked in heart among high volume centers", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:26:02.349+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "bc6555d0-3b63-4cc6-b33b-4dfcd60c472a", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "“They enrolled some of the highest-volume transplant centers in their clinical trial and these were the main ones that were using them until the last couple of years where amongst our group of folks that we talk to across the country who are other high-volume transplant centers as well, there’s been a steady decrease in utilization of TransMedics.” — Transplant cardiologist at one of the top centers in the US/world", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:23+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5374-767b-b3bc-70b5b9e837f9", "parentComponentId": null }, { "bbox": { "h": 0.02, "w": 0.3, "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:26:02.349+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "12fc2df5-1a39-47a0-bc86-95bc2205afb9", "parentComponentId": null }, { "bbox": { "h": 0.25, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "title", "text": "Vanderbilt indicated that TransMedics “absolutely” has no value proposition, with an exodus from the device among the top centers and those who participated in its trials", "attrs": null, "canon": { "kind": { "name": "Title", "slug": "title", "status": "active", "canonId": "019de52c-f7dd-76d9-b848-b1f12bd85cf4", "version": 1, "description": "Slide title or headline." }, "tool": null, "subkind": { "name": "Headline", "slug": "headline", "status": "active", "canonId": "019de52c-fae1-7463-9a7c-d60668eced0d", "version": 1, "description": null }, "framework": null }, "subkind": "headline", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:26:02.349+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "27543c85-f61d-4f6c-8e87-592d35937806", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [], "arcBeats": [], "loops": [], "locked": true }, { "page": 299, "type": "setup", "title": "The slide presents a synthesis of expert commentary followed by verbatim Q&A excerpts highlighting the 'last resort' nature of the current service and the futur", "function": "summarize", "rawType": "testimonial", "block": null, "metadata": { "slideType": "testimonial", "slideTypeCanon": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52d-0a2d-7782-8a48-7e84df92cc97", "version": 1, "description": null }, "function": "summarize", "functionCanon": { "name": "Summarize", "slug": "summarize", "status": "active", "canonId": "019de52d-1541-704f-b86f-bf7b75056373", "version": 1, "description": null }, "density": "dense", "densityScore": 72, "componentCount": 8, "textChars": 3520, "nDataPoints": 0, "notes": "The slide presents a synthesis of expert commentary followed by verbatim Q&A excerpts highlighting the 'last resort' nature of the current service and the future growth thesis.", "elementsJson": [ "paragraph", "quote_block", "footnote" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 21:26:03.199+00", "seconds": 3.926, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/299", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-299", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": { "h": 0.03, "w": 0.55, "x": 0.07, "y": 0.72 }, "kind": "callout", "text": "No value proposition; just for some smaller programs who need surgeons to retrieve a heart", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": null, "subkind": { "name": "Primary callout", "slug": "primary", "status": "active", "canonId": "019de52c-fbd1-70eb-a9ce-8997f8674c1d", "version": 1, "description": null }, "framework": null }, "subkind": "primary", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:26:03.199+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "c3fae4c7-2534-4279-b8e4-085463087e1c", "parentComponentId": null }, { "bbox": { "h": 0.03, "w": 0.35, "x": 0.07, "y": 0.44 }, "kind": "callout", "text": "“NRP is going to rapidly skyrocket in utilization”", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": null, "subkind": { "name": "Primary callout", "slug": "primary", "status": "active", "canonId": "019de52c-fbd1-70eb-a9ce-8997f8674c1d", "version": 1, "description": null }, "framework": null }, "subkind": "primary", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:26:03.199+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "e800a11f-d3d6-474e-9dd4-49d3ed9952e3", "parentComponentId": null }, { "bbox": null, "kind": "callout", "text": "NRP is going to rapidly utilize, and that a trickle-down effect from larger centers will lead the smaller centers - TransMedics last bastion of usage - to wind down as well.", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:23+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5374-767b-b3bb-dc91d88c893e", "parentComponentId": null }, { "bbox": { "h": 0.22, "w": 0.86, "x": 0.07, "y": 0.48 }, "kind": "paragraph", "text": "Q: “How much traction is NRP getting? Because if it’s taking off, then that’s going to be bad for TransMedics.”\nA: “NRP really is taking off, especially for DCD organ.”\nQ: “For DCD, it’s all going to be about NRP, basically. You’re seeing that take off in all the big academic centers?”\nA: “At the big academic centers, for sure. And I think as more and more big academic centers do these and they start spreading their surgeon graduates or their faculty surgeons around to other centers as well because that’s normal. There’s some degree of turnover at academic centers. We’re going to see smaller programs that don’t have an NRP program to start building their own ones as well. I do expect that lung DCD is going to be a much bigger deal in the next five years and two, NRP is going to rapidly skyrocket in utilization..” -Transplant cardiologist at one of the top centers in the US/world", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:26:03.199+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "8f01a602-25f6-402c-9e81-58e4d04f7691", "parentComponentId": null }, { "bbox": { "h": 0.18, "w": 0.86, "x": 0.07, "y": 0.76 }, "kind": "paragraph", "text": "Q: “So you haven’t seen much of a value proposition. You’re just using them as an on-call procurement service when you’re in a pinch?”\nA: “Essentially, yeah. I think the programs that may have the potential and the biggest benefit in utilizing OCS currently are these smaller programs trying to build up their transplant volume who don’t have the upfront institutional capital or protocols in terms of NRP procurement, etc., so they can just hand off the procurement to another team [...] my suspicion, honestly, is more utilization at those low to mid-range programs who don’t have surgeon bandwidth, who don’t have to worry about trying to put in the upfront organization cost that are required to build up an NRP program because that’s still relatively new in the game. It’s been around for less time than the OCS system, so it’s harder to gain traction because you have to build your surgeon’s experience and your team’s experience with it, which takes more money in the beginning.” -Transplant cardiologist at one of the top centers in the US/world", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:26:03.199+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "d6d25658-b526-4ba0-813e-19ad6f7d4c0f", "parentComponentId": null }, { "bbox": { "h": 0.35, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "paragraph", "text": "The cardiologist indicated that their remaining use of the heart device is solely as a last resort when their surgeons are tied up and they send an NOP retrieval team, which then bundles the device with the procurement service; and that, at best, their value proposition is for small centers without enough surgeons. However, he stated that “NRP is going to rapidly skyrocket in utilization,” and that a trickle-down effect from larger centers will lead the smaller centers - TransMedics last bastion of usage - to wind down as well: “NRP really is taking off...as more and more big academic centers...start spreading their surgeon graduates...around to other centers...we’re going to see smaller programs that don’t have an NRP program to start building their own”; “my suspicion, honestly, is more utilization at those low to mid-range programs who don’t have surgeon bandwidth.”", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:26:03.199+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "f58ad470-b341-4da4-82a9-ed7ca0b9f487", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "NRP is going to rapidly skyrocket in utilization... as more and more big academic centers... start spreading their surgeon graduates... around to other centers... we're going to see smaller programs that don't have an NRP program to start building their own. — Transplant cardiologist at one of the top centers in the US/world", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:23+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5374-767b-b3bb-e2c9d289a4a8", "parentComponentId": null }, { "bbox": { "h": 0.02, "w": 0.25, "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:26:03.199+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "76e27065-2e29-49e8-af15-b765a38e12bf", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [], "arcBeats": [], "loops": [], "locked": true }, { "page": 300, "type": "setup", "title": "The slide uses direct quotes from surgeons and an ex-employee to build a case against the viability of the NOP service for heart transplants.", "function": "preempt_rebuttal", "rawType": "preempt_rebuttal", "block": null, "metadata": { "slideType": "preempt_rebuttal", "slideTypeCanon": { "name": "Preempt rebuttal", "slug": "preempt_rebuttal", "status": "active", "canonId": "019de52d-1225-7368-af32-6381fddabdb3", "version": 1, "description": null }, "function": "preempt_rebuttal", "functionCanon": { "name": "Preempt rebuttal", "slug": "preempt_rebuttal", "status": "active", "canonId": "019de52d-18ab-7479-9a7e-820a2f03586a", "version": 1, "description": null }, "density": "dense", "densityScore": 74, "componentCount": 9, "textChars": 1994, "nDataPoints": 0, "notes": "The slide uses direct quotes from surgeons and an ex-employee to build a case against the viability of the NOP service for heart transplants.", "elementsJson": [ "paragraph", "quote_block", "footnote" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 21:26:03.164+00", "seconds": 3.491, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/300", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-300", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "Lack of trust in third-party procurement surgeons is an insurmountable barrier in heart", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:23+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5374-767b-b3bb-6dd3aa478d9e", "parentComponentId": null }, { "bbox": { "h": 0.06, "w": 0.86, "x": 0.07, "y": 0.8 }, "kind": "paragraph", "text": "TransMedics NOP unable to meet heart surgeon requirements. The heart community is less comfortable with us. They rush to the point that if you are flying a plane that needs to stop to refuel, they will say no, get us a bigger plane that can fly farther.", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:26:03.164+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "3dfa3813-2a5b-4cc9-aeba-24c017d89ddd", "parentComponentId": null }, { "bbox": { "h": 0.12, "w": 0.86, "x": 0.07, "y": 0.51 }, "kind": "paragraph", "text": "Zero value proposition for NOP in heart. Liver surgeons are more likely to use the NOP program because they're okay with having someone else recover the liver. Whereas in cardiac transplantation, you're going to have a dead recipient on your hands.", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:26:03.164+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "62ba2fb9-4245-480e-ba11-127ad95722e3", "parentComponentId": null }, { "bbox": { "h": 0.06, "w": 0.86, "x": 0.07, "y": 0.67 }, "kind": "paragraph", "text": "Lack of trust in third-party procurement surgeons is an insurmountable barrier in heart. A procurement service is counter to the way hearts and lungs have been harvested because they are infrequent events compared to routine heart operations.", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:26:03.164+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "996c721a-cded-438f-bd23-d90da5104d53", "parentComponentId": null }, { "bbox": { "h": 0.06, "w": 0.86, "x": 0.07, "y": 0.73 }, "kind": "quote", "text": "Do I trust somebody that I don't know personally to go cut out an organ from a donor, bring it back to me, and I trust that they've done it correctly and haven't screwed it up? That's a big trust factor that's a hard to overcome.", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Pull quote", "slug": "pull-quote", "status": "active", "canonId": "019de52c-fbf9-76fe-97e1-a0b7540445c9", "version": 1, "description": null }, "framework": null }, "subkind": "pull-quote", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:26:03.164+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "0068db0f-1ae5-41ca-8d65-8d3b32112dcf", "parentComponentId": null }, { "bbox": { "h": 0.08, "w": 0.86, "x": 0.07, "y": 0.58 }, "kind": "quote", "text": "I don't know anybody in cardiac transplant as opposed to liver that are using a TransMedics-hired surgeon...the NOP market, the soup-to-nuts offering, is useless for cardiac because I don't know many cardiac surgeons that would ever trust anybody except their own surgeons.", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Pull quote", "slug": "pull-quote", "status": "active", "canonId": "019de52c-fbf9-76fe-97e1-a0b7540445c9", "version": 1, "description": null }, "framework": null }, "subkind": "pull-quote", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:26:03.164+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "6020cef5-bc6a-4a06-bf8c-eddfc3e763a9", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "“I don't know anybody in cardiac transplant as opposed to liver that are using a TransMedics-hired surgeon...the NOP market, the soup-to-nuts offering, is useless for cardiac because I don't know many cardiac surgeons that would ever trust anybody except their own surgeons.” — Prominent surgeon, Director of leading academic transplant center", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:23+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5374-767b-b3bb-71bc483ab960", "parentComponentId": null }, { "bbox": { "h": 0.02, "w": 0.3, "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:26:03.164+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "73d3f5c4-fe55-4366-b5cc-6c650cf138b6", "parentComponentId": null }, { "bbox": { "h": 0.15, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "title", "text": "Cardiac surgeons indicated that TransMedics NOP procurement/transport service has no value proposition for heart, leaving aside the device – they have no trust in third-party retrieval surgeons; and they demand hearts back faster than the NOP service can fly them", "attrs": null, "canon": { "kind": { "name": "Title", "slug": "title", "status": "active", "canonId": "019de52c-f7dd-76d9-b848-b1f12bd85cf4", "version": 1, "description": "Slide title or headline." }, "tool": null, "subkind": { "name": "Headline", "slug": "headline", "status": "active", "canonId": "019de52c-fae1-7463-9a7c-d60668eced0d", "version": 1, "description": null }, "framework": null }, "subkind": "headline", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:26:03.164+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "9795e534-442c-4a78-8c28-721638fa35d2", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [ { "matchId": "5dde01d7-e6c7-45f4-8707-3c85507a9f73", "evidence": "The slide systematically presents negative expert testimony to invalidate a specific business offering.", "framework": null, "confidence": 0.9, "extraction": { "at": "2026-05-02 21:26:03.164+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 300, "frameworkName": "preempt_rebuttal" } ], "arcBeats": [], "loops": [], "locked": true }, { "page": 301, "type": "tension", "title": "The slide uses direct quotes and Q&A transcripts to undermine the clinical value proposition of the TransMedics device.", "function": "expose_contradiction", "rawType": "expose_contradiction", "block": null, "metadata": { "slideType": "expose_contradiction", "slideTypeCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-124c-75aa-984a-0a3d0d8fc8df", "version": 1, "description": null }, "function": "expose_contradiction", "functionCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-171f-776f-887c-73edaff4cf9c", "version": 1, "description": null }, "density": "balanced", "densityScore": 46, "componentCount": 6, "textChars": 1239, "nDataPoints": 1, "notes": "The slide uses direct quotes and Q&A transcripts to undermine the clinical value proposition of the TransMedics device.", "elementsJson": [ "paragraph", "quote_block", "footnote" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 21:26:02.526+00", "seconds": 2.53, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/301", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-301", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "UCSF surgeons only use occasionally for convenience, not for clinical reasons", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:23+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5374-767b-b3bb-9d3543f64e2c", "parentComponentId": null }, { "bbox": { "h": 0.25, "w": 0.86, "x": 0.07, "y": 0.65 }, "kind": "paragraph", "text": "UCSF discontinuing use for heart; almost no use in lung despite big program. The heart program, our surgical director is really aggressive and wants to be doing NRP for every donor, so I think his goal would be to discontinue TransMedics.", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:26:02.526+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "04d5ab1c-772e-4133-af3b-36878f03687b", "parentComponentId": null }, { "bbox": { "h": 0.25, "w": 0.86, "x": 0.07, "y": 0.35 }, "kind": "paragraph", "text": "UCSF surgeons only use occasionally for convenience, not for clinical reasons. Our heart transplant group was using it because they might not have a procurement surgeon available to go get a heart.", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:26:02.526+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "2cfb0af1-5cf5-4bc3-bce4-05e2063613a8", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "“Our heart transplant group was using it because they might not have a procurement surgeon available to go get a heart. It's not like anything required the device but they would use TransMedics out of convenience, which is a very expensive backup plan if you don't have a surgeon. We've since remedied that. We no longer have any issues with covering the procurement schedule, but for a while, we were using it even when it wasn't clinically indicated.” — UCSF administrator", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:23+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5374-767b-b3bb-a0a451eb6388", "parentComponentId": null }, { "bbox": { "h": 0.03, "w": 0.3, "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:26:02.526+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "aa8c3b45-98f1-4039-bbc7-c1528ce8b1a7", "parentComponentId": null }, { "bbox": { "h": 0.25, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "title", "text": "UCSF, Massachusetts General, and other top centers indicated the TransMedics heart pump serves no clinical purpose and is detrimental to the heart, confirming the devastating color from Vanderbilt.", "attrs": null, "canon": { "kind": { "name": "Title", "slug": "title", "status": "active", "canonId": "019de52c-f7dd-76d9-b848-b1f12bd85cf4", "version": 1, "description": "Slide title or headline." }, "tool": null, "subkind": { "name": "Headline", "slug": "headline", "status": "active", "canonId": "019de52c-fae1-7463-9a7c-d60668eced0d", "version": 1, "description": null }, "framework": null }, "subkind": "headline", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:26:02.526+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "178fb4d8-7525-4cfe-8a89-516fe34583de", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [ { "matchId": "8cf44e10-109d-4c5f-b45e-ce94f347035e", "evidence": "The slide uses expert testimony to contradict the company's clinical value proposition.", "framework": null, "confidence": 0.9, "extraction": { "at": "2026-05-02 21:26:02.526+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 301, "frameworkName": "fraud-exposure" } ], "arcBeats": [], "loops": [], "locked": true }, { "page": 302, "type": "tension", "title": "The slide uses direct quotes to undermine the value proposition of the OCS device.", "function": "expose_contradiction", "rawType": "villain_critique", "block": null, "metadata": { "slideType": "villain_critique", "slideTypeCanon": { "name": "Villain critique", "slug": "villain_critique", "status": "active", "canonId": "019de52d-10bc-7136-bf20-09de59d17447", "version": 1, "description": null }, "function": "expose_contradiction", "functionCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-171f-776f-887c-73edaff4cf9c", "version": 1, "description": null }, "density": "overcrowded", "densityScore": 78, "componentCount": 9, "textChars": 2806, "nDataPoints": 0, "notes": "The slide uses direct quotes to undermine the value proposition of the OCS device.", "elementsJson": [ "paragraph", "quote_block", "footnote" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 21:26:03.722+00", "seconds": 3.684, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/302", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-302", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "Massachusetts General indicated the lung product has no use case and that cold storage is superior – universal feedback across our customer calls; and that the device is dangerous to hearts", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:23+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5374-767b-b3bc-3c97df048d2f", "parentComponentId": null }, { "bbox": { "h": 0.08, "w": 0.9, "x": 0.07, "y": 0.36 }, "kind": "paragraph", "text": "A: “For lungs, it’s more of the fact that we don’t see a use for OCS. We use a different device that’s static cold storage and the lungs are much more resilient than the heart, and so, we’ve actually done a lot more research around that. We actually prefer using that method versus using the OCS and it would take a whole different team to go out there. It’s called Lung Guard.”", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:26:03.722+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "202aefdb-82e5-43bd-bf87-51bdabb50717", "parentComponentId": null }, { "bbox": { "h": 0.22, "w": 0.9, "x": 0.07, "y": 0.48 }, "kind": "paragraph", "text": "A: “With lung, it’s a little bit of everything. One is that the amount of centers that have lung transplants is much less than any other organ. Two, the lung distribution continues to expand everything way beyond what we were able to do. Three, the procuring teams for certain lungs, it’s very, very limited. So, even though there might be an excess of lungs, the team available to get those lungs to the right recipient is much less, so you really have a supply and demand issue. And then, I would just almost say four. It’s also because the lungs are very resilient; they can be tuned up much easier than a heart or a liver, and we have a better technology that can put a lung that’s more resilient on it in static cold storage manned or shipped unmanned to the final destination of the recipient hospital. And the lungs are fine. So, there’s a little bit more of a different approach for lungs than there are for hearts and livers.” – Veteran transplant administrator at Massachusetts General Hospital", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:26:03.722+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "54b27cb0-fff6-48dc-9293-cc786d8cd25c", "parentComponentId": null }, { "bbox": { "h": 0.02, "w": 0.5, "x": 0.07, "y": 0.33 }, "kind": "paragraph", "text": "MGH won’t use for lungs; no value proposition versus cold storage", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:26:03.722+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "58a81152-f33a-4e98-8c59-d3b4d5074817", "parentComponentId": null }, { "bbox": { "h": 0.12, "w": 0.9, "x": 0.07, "y": 0.74 }, "kind": "paragraph", "text": "“Our team goes out and procures the heart, and it’s usually used in conjunction with DCD hearts. And the duration on pump is much shorter. For heart transplant, there is some functionality that’s assessed on the pump, but the duration on the pump is much shorter because the hearts tend to get boggy and fluid overloaded and congested on the pump…you don’t want to keep the heart too long on pump.” – Veteran transplant administrator at Massachusetts General Hospital", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:26:03.722+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "82ec732b-532f-4375-9df7-7c8fb0bba2cc", "parentComponentId": null }, { "bbox": { "h": 0.02, "w": 0.3, "x": 0.07, "y": 0.71 }, "kind": "paragraph", "text": "Pump adversely affects hearts", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:26:03.722+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "8dcbc5c2-b6ae-4a01-b2fe-8e968d14c260", "parentComponentId": null }, { "bbox": { "h": 0.04, "w": 0.9, "x": 0.07, "y": 0.44 }, "kind": "paragraph", "text": "Q: “What’s the cost of that, just so I know the comparison to OCS? Their lung business has gone nowhere, so obviously, nobody’s really using it for lung.”", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:26:03.722+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "b0326cac-7577-475a-a25f-b92fcb7471fe", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "“For lungs, it's more of the fact that we don't see a use for OCS. We use a different device that's static cold storage and the lungs are much more resilient than the heart... It's called Lung Guard.” — Veteran transplant administrator at Massachusetts General Hospital; “hearts tend to get boggy and fluid overloaded and congested on the pump…you don't want to keep the heart too long on pump.” — Veteran transplant administrator at Massachusetts General Hospital", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:23+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5374-767b-b3bc-4362fcb57d21", "parentComponentId": null }, { "bbox": { "h": 0.02, "w": 0.3, "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:26:03.722+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "2c8307bf-805f-4210-93f3-4658aeb00a9c", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [], "arcBeats": [], "loops": [], "locked": true }, { "page": 303, "type": "tension", "title": "This is a text-only slide serving as a section header or key point in a research note.", "function": "name_villain", "rawType": "villain_critique", "block": null, "metadata": { "slideType": "villain_critique", "slideTypeCanon": { "name": "Villain critique", "slug": "villain_critique", "status": "active", "canonId": "019de52d-10bc-7136-bf20-09de59d17447", "version": 1, "description": null }, "function": "name_villain", "functionCanon": { "name": "Name villain", "slug": "name_villain", "status": "active", "canonId": "019de52d-1746-70d6-bc58-5eeaf5865526", "version": 1, "description": null }, "density": "sparse", "densityScore": 11, "componentCount": 3, "textChars": 372, "nDataPoints": 0, "notes": "This is a text-only slide serving as a section header or key point in a research note.", "elementsJson": [ "paragraph" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 21:26:02.341+00", "seconds": 1.827, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/303", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-303", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "TransMedics is being rapidly replaced by superior devices at a fraction of the cost, which began rolling out only recently.", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:22+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5374-767b-b3bb-5ff6bc03098b", "parentComponentId": null }, { "bbox": { "h": 0.069, "w": 0.854, "x": 0.073, "y": 0.098 }, "kind": "paragraph", "text": "TransMedics is being rapidly replaced by superior devices at a fraction of the cost, which began rolling out only recently. Customer interviews indicate delivery of OrganOx, Paragonix, and other devices at a weekly clip.", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:26:02.341+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "89d6f805-ab3f-45ad-a19e-951ab936dc4b", "parentComponentId": null }, { "bbox": { "h": 0.023, "w": 0.275, "x": 0.073, "y": 0.069 }, "kind": "title", "text": "Part 13. Competitive tsunami.", "attrs": null, "canon": { "kind": { "name": "Title", "slug": "title", "status": "active", "canonId": "019de52c-f7dd-76d9-b848-b1f12bd85cf4", "version": 1, "description": "Slide title or headline." }, "tool": null, "subkind": { "name": "Headline", "slug": "headline", "status": "active", "canonId": "019de52c-fae1-7463-9a7c-d60668eced0d", "version": 1, "description": null }, "framework": null }, "subkind": "headline", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:26:02.341+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "310b45db-ad7c-468b-ada2-4bf0eb6be474", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [], "arcBeats": [], "loops": [], "locked": true }, { "page": 304, "type": "tension", "title": "The slide uses direct quotes from surgeons to build a bearish case against the company (TransMedics/Waleed).", "function": "name_villain", "rawType": "villain_critique", "block": null, "metadata": { "slideType": "villain_critique", "slideTypeCanon": { "name": "Villain critique", "slug": "villain_critique", "status": "active", "canonId": "019de52d-10bc-7136-bf20-09de59d17447", "version": 1, "description": null }, "function": "name_villain", "functionCanon": { "name": "Name villain", "slug": "name_villain", "status": "active", "canonId": "019de52d-1746-70d6-bc58-5eeaf5865526", "version": 1, "description": null }, "density": "dense", "densityScore": 64, "componentCount": 8, "textChars": 1240, "nDataPoints": 4, "notes": "The slide uses direct quotes from surgeons to build a bearish case against the company (TransMedics/Waleed).", "elementsJson": [ "paragraph", "callout_box" ], "confidence": 0.95, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 21:26:03.636+00", "seconds": 3.064, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/304", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-304", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": { "h": 0.03, "w": 0.5, "x": 0.07, "y": 0.62 }, "kind": "callout", "text": "Management should be “selling stock like mad” due to competition", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": null, "subkind": { "name": "Primary callout", "slug": "primary", "status": "active", "canonId": "019de52c-fbd1-70eb-a9ce-8997f8674c1d", "version": 1, "description": null }, "framework": null }, "subkind": "primary", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:26:03.636+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "003ee1b9-912f-4f51-b2b6-e1c2fa5d037d", "parentComponentId": null }, { "bbox": { "h": 0.03, "w": 0.5, "x": 0.07, "y": 0.8 }, "kind": "callout", "text": "Stock will crash with new entrants which are already coming online", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": null, "subkind": { "name": "Primary callout", "slug": "primary", "status": "active", "canonId": "019de52c-fbd1-70eb-a9ce-8997f8674c1d", "version": 1, "description": null }, "framework": null }, "subkind": "primary", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:26:03.636+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "3baf142d-0c37-4a5f-9ac2-bb5ee8e0e3ae", "parentComponentId": null }, { "bbox": null, "kind": "callout", "text": "If I were Waleed’s people, I’d be selling stock like mad", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:23+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5374-767b-b3bb-c94c7b80a881", "parentComponentId": null }, { "bbox": { "h": 0.45, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "paragraph", "text": "It is rare to see a medical device company in the middle of such a rapidly unfolding tsunami of new entrants and competitive disruption. The typical transition from monopoly device to a crowded space involves devices that are cheaper or superior...", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:26:03.636+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "45bfe598-55f7-4f66-8bdf-ccbbf50d604b", "parentComponentId": null }, { "bbox": { "h": 0.12, "w": 0.86, "x": 0.07, "y": 0.83 }, "kind": "quote", "text": "My own take is that they're sort of riding a wave right now. The stock is way over-priced, and that thing is going to fall because once these devices come in and NRP catches on, people will see...", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:26:03.636+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "388662f9-39aa-44ea-83ea-cf3f08454e94", "parentComponentId": null }, { "bbox": { "h": 0.12, "w": 0.86, "x": 0.07, "y": 0.66 }, "kind": "quote", "text": "I think that they know damn well - Waleed said they're making a device that's going to look a lot like XVIVO's heart box... If I were Waleed's people, I'd be selling stock like mad.", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:26:03.636+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "ebf608f1-27e8-40b9-9a93-f121328c8b30", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "“if I were Waleed’s people, I’d be selling stock like mad” – “I think they know damn well” that they’re in trouble. Another surgeon: “they’re sort of riding a wave right now...the stock is way over-priced and that thing is going to fall because once these devices come in and NRP catches on, people will see....” — Prominent surgeon, director of a leading transplant center", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:23+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5374-767b-b3bb-cde68cab70ce", "parentComponentId": null }, { "bbox": { "h": 0.02, "w": 0.3, "x": 0.07, "y": 0.96 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:26:03.636+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "0fceb689-f267-447a-b8f8-e08449e473dd", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [ { "matchId": "d607c948-dfce-4689-96ca-fab2f81a729b", "evidence": "Uses expert surgeon testimonials to validate the bearish thesis.", "framework": null, "confidence": 0.9, "extraction": { "at": "2026-05-02 21:26:03.636+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 304, "frameworkName": "authority-citation" } ], "arcBeats": [], "loops": [], "locked": true }, { "page": 305, "type": "setup", "title": "The slide uses a 'laundry list' format to present competitive threats, supported by product imagery.", "function": "compare_peers", "rawType": "competitive_analysis", "block": null, "metadata": { "slideType": "competitive_analysis", "slideTypeCanon": { "name": "Competitive analysis", "slug": "competitive_analysis", "status": "active", "canonId": "019de52d-093e-776b-94c6-c1573f5f1a31", "version": 1, "description": null }, "function": "compare_peers", "functionCanon": { "name": "Compare peers", "slug": "compare_peers", "status": "active", "canonId": "019de52d-1453-72ba-a367-9ba3d34c1630", "version": 1, "description": null }, "density": "balanced", "densityScore": 37, "componentCount": 7, "textChars": 480, "nDataPoints": 1, "notes": "The slide uses a 'laundry list' format to present competitive threats, supported by product imagery.", "elementsJson": [ "paragraph", "numbered_list", "photo" ], "confidence": 0.95, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 21:26:03.662+00", "seconds": 2.985, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/305", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-305", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "NRP, which is currently spreading like wildfire and renders TransMedics obsolete.", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:23+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5374-767b-b3bb-f4737591b075", "parentComponentId": null }, { "bbox": { "h": 0.35, "w": 0.16, "x": 0.55, "y": 0.52 }, "kind": "image", "text": "LifePort device image", "attrs": null, "canon": { "kind": { "name": "Image", "slug": "image", "status": "active", "canonId": "019de52c-f978-701f-a720-51d029d769e7", "version": 1, "description": "Photo, illustration, screenshot or icon." }, "tool": null, "subkind": { "name": "Illustration", "slug": "illustration", "status": "active", "canonId": "019de52c-fe76-7772-a5ac-c0b7294d7615", "version": 1, "description": null }, "framework": null }, "subkind": "illustration", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:26:03.662+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "5d00ec4b-5fe3-425d-97fc-9e71c3131e17", "parentComponentId": null }, { "bbox": { "h": 0.35, "w": 0.21, "x": 0.07, "y": 0.52 }, "kind": "image", "text": "OrganOx device image", "attrs": null, "canon": { "kind": { "name": "Image", "slug": "image", "status": "active", "canonId": "019de52c-f978-701f-a720-51d029d769e7", "version": 1, "description": "Photo, illustration, screenshot or icon." }, "tool": null, "subkind": { "name": "Illustration", "slug": "illustration", "status": "active", "canonId": "019de52c-fe76-7772-a5ac-c0b7294d7615", "version": 1, "description": null }, "framework": null }, "subkind": "illustration", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:26:03.662+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "6e78c62e-9f4c-4d28-8489-7462a2d45d28", "parentComponentId": null }, { "bbox": { "h": 0.35, "w": 0.21, "x": 0.31, "y": 0.52 }, "kind": "image", "text": "Paragonix device image", "attrs": null, "canon": { "kind": { "name": "Image", "slug": "image", "status": "active", "canonId": "019de52c-f978-701f-a720-51d029d769e7", "version": 1, "description": "Photo, illustration, screenshot or icon." }, "tool": null, "subkind": { "name": "Illustration", "slug": "illustration", "status": "active", "canonId": "019de52c-fe76-7772-a5ac-c0b7294d7615", "version": 1, "description": null }, "framework": null }, "subkind": "illustration", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:26:03.662+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "a26a0030-8434-4425-80b9-906391456a3d", "parentComponentId": null }, { "bbox": { "h": 0.35, "w": 0.19, "x": 0.74, "y": 0.52 }, "kind": "image", "text": "XVIVO device image", "attrs": null, "canon": { "kind": { "name": "Image", "slug": "image", "status": "active", "canonId": "019de52c-f978-701f-a720-51d029d769e7", "version": 1, "description": "Photo, illustration, screenshot or icon." }, "tool": null, "subkind": { "name": "Illustration", "slug": "illustration", "status": "active", "canonId": "019de52c-fe76-7772-a5ac-c0b7294d7615", "version": 1, "description": null }, "framework": null }, "subkind": "illustration", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:26:03.662+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "e924cf78-0958-4fba-b846-af0f0468fac3", "parentComponentId": null }, { "bbox": { "h": 0.35, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "paragraph", "text": "The surgeons provided a laundry list of newer devices and technologies: 1) OrganOx, normothermic pump basically identical to TransMedics OCS and less than a third of the cost... 7) NRP, which is currently spreading like wildfire and renders TransMedics obsolete.", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:26:03.662+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "eebe93e3-ffa2-43a5-a3d7-3c5eadb3826b", "parentComponentId": null }, { "bbox": { "h": 0.03, "w": 0.3, "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:26:03.662+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "f1dfc7bb-86b5-4abf-b889-f7b3a5b88487", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [], "arcBeats": [], "loops": [], "locked": true }, { "page": 306, "type": "tension", "title": "The slide uses a 'villain' narrative structure to frame TransMedics as vulnerable to upcoming competition.", "function": "expose_contradiction", "rawType": "testimonial", "block": null, "metadata": { "slideType": "testimonial", "slideTypeCanon": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52d-0a2d-7782-8a48-7e84df92cc97", "version": 1, "description": null }, "function": "expose_contradiction", "functionCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-171f-776f-887c-73edaff4cf9c", "version": 1, "description": null }, "density": "dense", "densityScore": 61, "componentCount": 7, "textChars": 2346, "nDataPoints": 0, "notes": "The slide uses a 'villain' narrative structure to frame TransMedics as vulnerable to upcoming competition.", "elementsJson": [ "paragraph", "quote_block" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 21:26:03.969+00", "seconds": 3.224, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/306", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-306", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "the cost is going to go down...you are going to have other competitors...people are going to start shifting gears...to a different pump because it's not sustainable.", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:24+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5374-767b-b3bd-77d3734115b0", "parentComponentId": null }, { "bbox": { "h": 0.25, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "paragraph", "text": "Surgeons indicate that the new devices are the buzz at transplant conferences, with the field eager to defect to alternatives given widespread alienation with TransMedics business practices – and that the company is basically toast.", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:26:03.969+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "2f6fb113-3ee7-4702-b1f3-47d618bc7565", "parentComponentId": null }, { "bbox": { "h": 0.13, "w": 0.86, "x": 0.07, "y": 0.51 }, "kind": "quote", "text": "Buzz at transplant conferences about new entrants and competition: 'This was certainly hallway conversations at ATC...'", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:26:03.969+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "122ed55a-d6c5-4700-900c-c8fcca30f82d", "parentComponentId": null }, { "bbox": { "h": 0.16, "w": 0.86, "x": 0.07, "y": 0.78 }, "kind": "quote", "text": "'Guaranteed' FDA approval for new entrants and market shift to different pumps: 'There’s going to be a point where the cost is going to go down...'", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:26:03.969+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "9b7671f5-019c-41ec-90f2-ab9bf7146325", "parentComponentId": null }, { "bbox": { "h": 0.08, "w": 0.86, "x": 0.07, "y": 0.67 }, "kind": "quote", "text": "Will be game with if new devices are comparable as so much cheaper: 'If there is not much of an advantage...'", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:26:03.969+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "f6f3c1f3-345d-4cd4-b2b9-fbbb173aceee", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "\"This was certainly hallway conversations at ATC. The discussion that people had in the hallways was, first of all, we’re glad there’s going to be competition, so TransMedics can’t be the only game in town. Almost everybody was saying that. Again, I’ll leave it to you whether this would devastate their earnings reports or not…this is not going to stay exclusive much longer.\" — Cardiothoracic transplant surgeon, director of a leading academic transplant center; \"If there is not much of an advantage of having this incredibly expensive setup versus a $30k different technology, then I think they’re going to have a very hard time selling it.\" — Transplant hepatologist and director of the liver program at a Midwest academic center; \"There’s going to be a point where the cost is going to go down. Right now, TransMedics doesn’t have big competition. The only competition is called OrganOX. That is the same type of machine perfusion. There are other new companies that are going through the FDA to get approved. Those are different types of pump like hyperthermic machine perfusion. So, I can guarantee you that these companies, they are going to get approved by the FDA. I think that in the next year or two years at the most, you are going to have other competitors with TransMedics. Because of the cost, people are going to start shifting gears, and they’re going to be changing to a different pump because it’s not sustainable for a transplant center...\" — Transplant surgeon in a leadership role at Vanderbilt", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:24+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5374-767b-b3bd-78b79cf89082", "parentComponentId": null }, { "bbox": { "h": 0.02, "w": 0.25, "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 21:26:03.969+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "9cea9460-19aa-4fed-b9e7-b899b162dcd5", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [ { "matchId": "68b67f49-86cf-4219-9d85-18a092de6529", "evidence": "Frames TransMedics as the 'villain' facing inevitable decline due to market competition.", "framework": null, "confidence": 0.9, "extraction": { "at": "2026-05-02 21:26:03.969+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 306, "frameworkName": "antagonist-introduction" } ], "arcBeats": [], "loops": [], "locked": true }, { "page": 307, "type": "tension", "title": "The slide uses expert testimony to build a bearish case against the incumbent (TransMedics).", "function": "expose_gap", "rawType": "testimonial", "block": null, "metadata": { "slideType": "testimonial", "slideTypeCanon": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52d-0a2d-7782-8a48-7e84df92cc97", "version": 1, "description": null }, "function": "expose_gap", "functionCanon": { "name": "Expose gap", "slug": "expose_gap", "status": "active", "canonId": "019de52d-1795-772d-8f3a-75ccfb93fe58", "version": 1, "description": null }, "density": "dense", "densityScore": 63, "componentCount": 8, "textChars": 1275, "nDataPoints": 1, "notes": "The slide uses expert testimony to build a bearish case against the incumbent (TransMedics).", "elementsJson": [ "paragraph", "callout_box" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:13:05.263+00", "seconds": 10.854, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/307", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-307", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "They're going to see significant market erosion, especially with liver being their major source of income. Liver is absolutely going to have competition from XVIVO and from LifePort 100%.", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:24+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5374-767b-b3bc-92f27c449d0f", "parentComponentId": null }, { "bbox": { "h": 0.25, "w": 0.9, "x": 0.05, "y": 0.15 }, "kind": "paragraph", "text": "In addition to being cheaper, surgeons stated the new devices have superior technology and trial data...", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:13:05.263+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "b39720d1-5b0c-4797-86bc-1893f5966b15", "parentComponentId": null }, { "bbox": { "h": 0.1, "w": 0.9, "x": 0.05, "y": 0.65 }, "kind": "quote", "text": "They're going to see significant market erosion, especially with liver being their major source of income.", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:13:05.263+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "4e24f0f8-702e-4ae3-9790-e9644dd547c5", "parentComponentId": null }, { "bbox": { "h": 0.1, "w": 0.9, "x": 0.05, "y": 0.8 }, "kind": "quote", "text": "The only companies in the U.S. approved for lung are XVIVO and TransMedics... For liver, the only FDA-approved device is the TransMedics OCS.", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:13:05.263+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "ae444fe2-17d3-4ec7-b8b8-ef6387f98585", "parentComponentId": null }, { "bbox": { "h": 0.15, "w": 0.9, "x": 0.05, "y": 0.45 }, "kind": "quote", "text": "I definitely think there are threats on the horizon... TransMedics is not going to be alone", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:13:05.263+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "b8a17cca-7d9a-4306-81c9-4530b0a0eb60", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "\"everything I know about LifePort and the research published out of Columbia shows that it is superior to TransMedics for liver\" — Transplant surgeon; \"I definitely think there are threats on the horizon\" — Transplant surgeon at a high-volume West Coast academic center; \"The only companies in the U.S. approved for lung are XVIVO and TransMedics. For heart, TransMedics is the only device approved, but they're competing against NRP, which is what we use.\" — Prominent surgeon, Director of leading West Coast academic transplant center", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:24+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5374-767b-b3bc-973d0abc2c0d", "parentComponentId": null }, { "bbox": { "h": 0.03, "w": 0.3, "x": 0.05, "y": 0.95 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:13:05.263+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "547e2f6d-5305-4bcb-800a-dd42b41ed7df", "parentComponentId": null }, { "bbox": { "h": 0.1, "w": 0.9, "x": 0.05, "y": 0.05 }, "kind": "title", "text": "Surgeon feedback on competitive threats to TransMedics", "attrs": null, "canon": { "kind": { "name": "Title", "slug": "title", "status": "active", "canonId": "019de52c-f7dd-76d9-b848-b1f12bd85cf4", "version": 1, "description": "Slide title or headline." }, "tool": null, "subkind": { "name": "Headline", "slug": "headline", "status": "active", "canonId": "019de52c-fae1-7463-9a7c-d60668eced0d", "version": 1, "description": null }, "framework": null }, "subkind": "headline", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:13:05.263+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "828bf01f-137d-4a0f-b167-c5d70d027ab1", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [], "arcBeats": [], "loops": [], "locked": true }, { "page": 308, "type": "tension", "title": "The slide uses expert testimony to undermine the value proposition of TransMedics' portability.", "function": "name_villain", "rawType": "villain_critique", "block": null, "metadata": { "slideType": "villain_critique", "slideTypeCanon": { "name": "Villain critique", "slug": "villain_critique", "status": "active", "canonId": "019de52d-10bc-7136-bf20-09de59d17447", "version": 1, "description": null }, "function": "name_villain", "functionCanon": { "name": "Name villain", "slug": "name_villain", "status": "active", "canonId": "019de52d-1746-70d6-bc58-5eeaf5865526", "version": 1, "description": null }, "density": "overcrowded", "densityScore": 76, "componentCount": 8, "textChars": 4031, "nDataPoints": 1, "notes": "The slide uses expert testimony to undermine the value proposition of TransMedics' portability.", "elementsJson": [ "paragraph", "quote_block", "footnote" ], "confidence": 0.95, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:13:08.369+00", "seconds": 12.969, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/308", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-308", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": { "h": 0.03, "w": 0.86, "x": 0.07, "y": 0.66 }, "kind": "callout", "text": "United Therapeutics’ Lung Bio-Engineering has already rigged 600 lungs at perfusion centers", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": null, "subkind": { "name": "Primary callout", "slug": "primary", "status": "active", "canonId": "019de52c-fbd1-70eb-a9ce-8997f8674c1d", "version": 1, "description": null }, "framework": null }, "subkind": "primary", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:13:08.369+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "31ab6cf9-2ed2-489e-94cd-f4964b867ffb", "parentComponentId": null }, { "bbox": { "h": 0.03, "w": 0.86, "x": 0.07, "y": 0.45 }, "kind": "callout", "text": "Back to base is superior, cheaper, no benefit to fully transportable perfusion pump", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": null, "subkind": { "name": "Primary callout", "slug": "primary", "status": "active", "canonId": "019de52c-fbd1-70eb-a9ce-8997f8674c1d", "version": 1, "description": null }, "framework": null }, "subkind": "primary", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:13:08.369+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "ffa0abe7-f675-4392-b484-eb57b728becb", "parentComponentId": null }, { "bbox": null, "kind": "callout", "text": "TransMedics portability is irrelevant, as its primary use case is not clinical but scheduling and convenience - in other words, it is already mostly used off-label as a back-to-base device while OR’s wait for surgeons to wake up or stack cases.", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:23+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5374-767b-b3bc-25c0055f0447", "parentComponentId": null }, { "bbox": { "h": 0.35, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "paragraph", "text": "Some of the newer systems are “back-to-base” which poses a particular threat to TransMedics, which is portable – “the data is not quite there to prove that a fully transportable device is superior, and logistically it’s easier and cheaper to Vita Smart rig the device after it’s been transported.” Non-portable pumps - located at hospitals, local OPO’s, or United Therapeutics dedicated perfusion centers – are less expensive and also provide more organ assessment and therapeutic capabilities, having no size constraints. TransMedics portability is irrelevant, as its primary use case is not clinical but scheduling and convenience – in other words, it is already mostly used off-label as a back-to-base device while OR’s wait for surgeons to wake up or stack cases. Moreover, our research indicated that a rapidly increasing use case is transporting organs to the center on ice and then putting them on TransMedics - precisely back-to-base usage.", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:13:08.369+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "01ab3314-bb73-4f30-b8b3-800176efc123", "parentComponentId": null }, { "bbox": { "h": 0.15, "w": 0.86, "x": 0.07, "y": 0.48 }, "kind": "quote", "text": "“Simultaneously and, in fact, ahead of TransMedics, XVIVO was working on this. They had a different concept. Instead of doing the fully transportable system that TransMedics has, their concept is what’s called “back to base.” And there are several companies are out there that are like that, including VitaSmart who along with XVIVO feel that the data is not actually quite there to prove that that a fully transportable device is actually superior, and logistically, it’s easier and could potentially be cheaper to rig the device after it’s been transported to the transplant center or to the OPO.” – Prominent surgeon, Director of leading West Coast academic transplant center", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:13:08.369+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "9348407f-d0b1-4420-8be2-31a1831cb76b", "parentComponentId": null }, { "bbox": { "h": 0.23, "w": 0.86, "x": 0.07, "y": 0.69 }, "kind": "quote", "text": "“Lung Bio-Engineering and United Therapeutics have a completely different business model, which is they have their recovery centers, one in Silver Springs, Maryland and the other in Jacksonville, Florida, associated with Mayo. They are rigging lungs, and they’re eventually going to do livers. [They] can physiologically evaluate a lot more than what TransMedics can do because they’re in a facility; they’re not just on a little portable machine. And if the organs are considered acceptable, in the case of lung, based on oxygenation, lung compliance, and pulmonary pressures, then the organ is flushed cold again and then transported to the transplant center. Just to give you an example that TransMedics is not alone in this enterprise, there have been over 600 lungs that have been rigged by the lung bioengineering folks in Maryland that have been transplanted from Toronto down to Duke all the way to Cleveland, New York at Columbia Presbyterian. So, this is not some Star Wars concept; this is something that’s practically going on, and they, in fact, are going to go for FDA approval third quarter of this year, is my understanding from what they’ve said at the meeting.” – Prominent surgeon, Director of leading West Coast academic transplant center", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:13:08.369+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "9ad08569-520c-4372-b159-4cc94308bd75", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "“Simultaneously and, in fact, ahead of TransMedics, XVIVO was working on this. They had a different concept. Instead of doing the fully transportable system that TransMedics has, their concept is what’s called “back to base.” And there are several companies are out there that are like that, including VitaSmart who along with XVIVO feel that the data is not actually quite there to prove that a fully transportable device is actually superior, and logistically, it’s easier and could potentially be cheaper to rig the device after it’s been transported to the transplant center or to the OPO.” — Prominent surgeon, Director of leading West Coast academic transplant center", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:23+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5374-767b-b3bc-287dbe52f92e", "parentComponentId": null }, { "bbox": { "h": 0.02, "w": 0.25, "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:13:08.369+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "09ba47b7-5f3f-4a4b-8440-5a8bbb7ab9b8", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [], "arcBeats": [], "loops": [], "locked": true }, { "page": 309, "type": "resolution", "title": "The slide uses direct quotes from an OrganOx employee and a leading transplant surgeon to validate the thesis.", "function": "summarize", "rawType": "key_takeaways", "block": null, "metadata": { "slideType": "key_takeaways", "slideTypeCanon": { "name": "Key takeaways", "slug": "key_takeaways", "status": "active", "canonId": "019de52d-06e7-7674-a891-9f7de3b11b6d", "version": 1, "description": null }, "function": "summarize", "functionCanon": { "name": "Summarize", "slug": "summarize", "status": "active", "canonId": "019de52d-1541-704f-b86f-bf7b75056373", "version": 1, "description": null }, "density": "overcrowded", "densityScore": 75, "componentCount": 8, "textChars": 2948, "nDataPoints": 2, "notes": "The slide uses direct quotes from an OrganOx employee and a leading transplant surgeon to validate the thesis.", "elementsJson": [ "paragraph", "quote_block", "footnote" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:13:05.095+00", "seconds": 9.687, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/309", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-309", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "OrganOx was about $30,000, so it's about half the price. That's why we elected to stay with OrganOx.", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:23+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5374-767b-b3bc-0db7a851830f", "parentComponentId": null }, { "bbox": { "h": 0.25, "w": 0.86, "x": 0.07, "y": 0.22 }, "kind": "paragraph", "text": "We spoke with an OrganOx senior medical employee: \"OrganOx is rapidly growing...they're expanding quite quickly...they're increasing their US presence quite a bit...things are going well.\" One of the top liver transplant surgeons and KOL's noted an unpublished paper he recently reviewed, which surveyed 43 transplant centers in the US - it indicated OrganOx already has more share than TransMedics: \"I hadn't heard this until I read it in the paper - more people are using OrganOx...in the United States than are using TransMedics...I would have thought it was the other way around.\" The surgeon indicated his center went with OrganOx over TransMedics: \"we elected not to do it for livers...OrganOx was about $30,000, so it's about half the price.\"", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:13:05.095+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "838f6b11-7113-4643-985b-bb94364c3631", "parentComponentId": null }, { "bbox": { "h": 0.12, "w": 0.86, "x": 0.07, "y": 0.83 }, "kind": "quote", "text": "Although we signed onto it for livers, we decided not to purchase it. Initially, you had to buy half a million dollars worth of devices. They were charging $60,000 each, and you had to buy 10 units. And so, basically, that was your investment into their program. So, we elected not to do it for livers. OrganOX was about $30,000, so it's about half the price. That's why we elected to stay with OrganOX.", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:13:05.095+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "28352af9-eb20-4504-b2bd-7eee2d1c003f", "parentComponentId": null }, { "bbox": { "h": 0.12, "w": 0.86, "x": 0.07, "y": 0.52 }, "kind": "quote", "text": "OrganOx is rapidly growing...they're expanding quite quickly...they're increasing their US presence quite a bit. They have a new physical presence in New Jersey. Things are going well...it's a virtual direct competitor to TransMedics...in layman's terms, you can think of it as a machine that does essentially the same thing...these are the only two normothermic machine perfusion devices on the market...there are a few others that are about to make an entry into the US market.", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:13:05.095+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "4a3f0017-0fb1-4cd1-9177-0ffdfec68689", "parentComponentId": null }, { "bbox": { "h": 0.12, "w": 0.86, "x": 0.07, "y": 0.68 }, "kind": "quote", "text": "I just reviewed this paper and it was a survey of all the transplant programs around the world. There were like 43 respondents in the United States, and what was interesting - and I hadn't heard this until I read it in this paper - more people using OrganOX for normothermic machine perfusion of livers in the United States than are using TransMedics. And I would have thought it was the other way around. I would have thought TransMedics was higher than OrganOX.", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:13:05.095+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "e8cd0dbc-86bf-4242-a5a7-da3d8bd9b5cb", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "\"OrganOx is rapidly growing...they're expanding quite quickly...they're increasing their US presence quite a bit...things are going well.\" — Senior medical employee at OrganOx. \"I hadn't heard this until I read it in the paper - more people are using OrganOX for normothermic machine perfusion of livers in the United States than are using TransMedics.\" — One of the top liver transplant surgeons in the world, based at a leading Midwest academic center.", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:23+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5374-767b-b3bc-126384ca8a96", "parentComponentId": null }, { "bbox": { "h": 0.02, "w": 0.25, "x": 0.07, "y": 0.96 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:13:05.095+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "ecd18e9e-c183-43a3-9911-93a5ede9d27e", "parentComponentId": null }, { "bbox": { "h": 0.15, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "title", "text": "Our research indicates OrganOx penetration is increasing rapidly and taking TransMedics market share – both are nearly identical normothermic pumps - with centers installing devices and getting trained, starting aggressively about 6 months ago.", "attrs": null, "canon": { "kind": { "name": "Title", "slug": "title", "status": "active", "canonId": "019de52c-f7dd-76d9-b848-b1f12bd85cf4", "version": 1, "description": "Slide title or headline." }, "tool": null, "subkind": { "name": "Headline", "slug": "headline", "status": "active", "canonId": "019de52c-fae1-7463-9a7c-d60668eced0d", "version": 1, "description": null }, "framework": null }, "subkind": "headline", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:13:05.095+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "7a7d812a-3f74-4d84-97e0-0ca1efbc7b3b", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [], "arcBeats": [], "loops": [], "locked": true }, { "page": 310, "type": "evidence", "title": "The slide uses direct quotes from transplant surgeons and hepatologists to validate the thesis of market disruption.", "function": "illustrate_case", "rawType": "testimonial", "block": null, "metadata": { "slideType": "testimonial", "slideTypeCanon": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52d-0a2d-7782-8a48-7e84df92cc97", "version": 1, "description": null }, "function": "illustrate_case", "functionCanon": { "name": "Illustrate case", "slug": "illustrate_case", "status": "active", "canonId": "019de52d-13b4-772c-bb73-1873612a7463", "version": 1, "description": null }, "density": "balanced", "densityScore": 34, "componentCount": 4, "textChars": 1271, "nDataPoints": 0, "notes": "The slide uses direct quotes from transplant surgeons and hepatologists to validate the thesis of market disruption.", "elementsJson": [ "paragraph", "callout_box", "footnote" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:13:03.406+00", "seconds": 7.469, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/310", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-310", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": { "h": 0.45, "w": 0.86, "x": 0.07, "y": 0.48 }, "kind": "list", "text": "OrganOx “coming out now” with huge pent up interest\nTransMedics use “goes down significantly” after receiving OrganOx machine\nOne of TransMedics largest customers just acquired OrganOx\nMGH: combo of back-to-base with OrganOx and NRP will make “TransMedics come down from its high horse”", "attrs": null, "canon": { "kind": { "name": "List", "slug": "list", "status": "active", "canonId": "019de52c-f94b-779b-a53b-fd4904a5f4d2", "version": 1, "description": "Bullet or numbered list." }, "tool": null, "subkind": { "name": "Bullet list", "slug": "bullet", "status": "active", "canonId": "019de52c-fc98-7169-a083-5cab805076ca", "version": 1, "description": null }, "framework": null }, "subkind": "bullet", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:13:03.406+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "33a76e20-e34b-41f0-9f63-d7ba01987fe1", "parentComponentId": null }, { "bbox": { "h": 0.25, "w": 0.86, "x": 0.07, "y": 0.22 }, "kind": "paragraph", "text": "The head of a large academic center in Pennsylvania: \"OrganOx is their main competitor...they’re coming out now...they have so many orders...it was like buying a Lexus when it first came out...you pay for it now and you’ll get it in 9 months....a third of the price....they literally don’t have enough machines...I’m not kidding...we have a contract out for one...we just don’t have it yet – and stated “it goes down significantly” when we asked how it will impact his TransMedics usage. Another surgeon – a top TransMedics customer who does ~100 livers a year with the device: “to be transparent, we actually just acquired an OrganOx for our institution.” A transplant hepatologist in a leadership role Massachusetts General noted good date for OrganOx’s approach and that it will “knock TransMedics off its high horse.”", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:13:03.406+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "d639eaba-062e-4040-87a7-9a79caf45e23", "parentComponentId": null }, { "bbox": { "h": 0.03, "w": 0.3, "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:13:03.406+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "248438a0-5ea5-4f75-b461-beb26043620e", "parentComponentId": null }, { "bbox": { "h": 0.15, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "title", "text": "Surgeons indicated enormous pent-up demand for OrganOx, which it was only recently able to start fulfilling.", "attrs": null, "canon": { "kind": { "name": "Title", "slug": "title", "status": "active", "canonId": "019de52c-f7dd-76d9-b848-b1f12bd85cf4", "version": 1, "description": "Slide title or headline." }, "tool": null, "subkind": { "name": "Headline", "slug": "headline", "status": "active", "canonId": "019de52c-fae1-7463-9a7c-d60668eced0d", "version": 1, "description": null }, "framework": null }, "subkind": "headline", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:13:03.406+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "2b3c2e57-551c-4751-aeae-a84f9bcbb554", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [], "arcBeats": [], "loops": [], "locked": true }, { "page": 311, "type": "tension", "title": "The slide highlights a competitive threat to TransMedics driven by OPO purchasing behavior.", "function": "expose_contradiction", "rawType": "testimonial", "block": null, "metadata": { "slideType": "testimonial", "slideTypeCanon": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52d-0a2d-7782-8a48-7e84df92cc97", "version": 1, "description": null }, "function": "expose_contradiction", "functionCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-171f-776f-887c-73edaff4cf9c", "version": 1, "description": null }, "density": "dense", "densityScore": 54, "componentCount": 6, "textChars": 1870, "nDataPoints": 1, "notes": "The slide highlights a competitive threat to TransMedics driven by OPO purchasing behavior.", "elementsJson": [ "paragraph", "callout_box" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:13:05.703+00", "seconds": 9.68, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/311", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-311", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "Tsunami of OrganOx and NRP will lead to collapse of TransMedics usage \"soon\"", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:24+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5374-767b-b3bc-a6426e769b15", "parentComponentId": null }, { "bbox": { "h": 0.18, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "paragraph", "text": "In addition to centers buying OrganOx directly, OPO’s – of which there are 57 that run the US organ transplant system under UNOS – are now purchasing the machines themselves to set up back-to-base facilities for all transplant centers in their territories, thus making machine perfusion essentially free for every hospital they work with.", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:13:05.703+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "394f168e-e3f3-40f6-9aef-9975815170db", "parentComponentId": null }, { "bbox": { "h": 0.14, "w": 0.86, "x": 0.07, "y": 0.77 }, "kind": "quote", "text": "If you see the liver use start to go down, I can tell you, at least for here in the Bay Area, it will all be attributed right away to OrganOX. They can’t produce the machines fast enough. We would have purchased three of them, but they can only give us one at the moment.", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:13:05.703+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "6cb3c8dd-e249-4408-a6ca-8148a037c0fa", "parentComponentId": null }, { "bbox": { "h": 0.12, "w": 0.86, "x": 0.07, "y": 0.58 }, "kind": "quote", "text": "Whether it’s because TransMedics is too expensive or OrganOX is better, there is a desire for our transplant center to do more OrganOX when it becomes available. So, once we go live with it, we anticipate anywhere from 35 to 50 cases a year...", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:13:05.703+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "bf249fca-9327-4830-b0ce-b440578ac4e9", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "\"Whether it’s because TransMedics is too expensive or OrganOX is better, there is a desire for our transplant center to do more OrganOX...that is a risk for the market share for TransMedics...liver is why OrganOX is taking off.\" — CFO of one of the largest OPO’s (organ procurement organizations) in the country. \"If you see the liver use start to go down, I can tell you, at least for here in the Bay Area, it will all be attributed right away to OrganOX. They can't produce the machines fast enough. We would have purchased three of them, but they can only give us one at the moment. So, then as soon as we deploy this program, we are in conversations with the perfusion group to bring in NRP. And if we want to provide NRP on 100% of our DCD donors, which is the bulk of the OCS liver machine use, is on those DCDs.\" — Executive at a leading West Coast OPO, longtime industry veteran", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:24+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5374-767b-b3bc-ab2f7f58cc34", "parentComponentId": null }, { "bbox": { "h": 0.03, "w": 0.3, "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:13:05.703+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "652b4d43-ab1e-44e4-8997-db6ace51f2da", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [], "arcBeats": [], "loops": [], "locked": true }, { "page": 312, "type": "tension", "title": "The slide uses direct quotes from an industry expert to build a bearish case against TransMedics.", "function": "expose_contradiction", "rawType": "testimonial", "block": null, "metadata": { "slideType": "testimonial", "slideTypeCanon": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52d-0a2d-7782-8a48-7e84df92cc97", "version": 1, "description": null }, "function": "expose_contradiction", "functionCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-171f-776f-887c-73edaff4cf9c", "version": 1, "description": null }, "density": "dense", "densityScore": 69, "componentCount": 8, "textChars": 2550, "nDataPoints": 0, "notes": "The slide uses direct quotes from an industry expert to build a bearish case against TransMedics.", "elementsJson": [ "paragraph", "callout_box", "footnote" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:13:05.964+00", "seconds": 9.913, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/312", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-312", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": { "h": 0.03, "w": 0.86, "x": 0.07, "y": 0.7 }, "kind": "callout", "text": "OPO’s aggressively moving to OrganOx; costs transplant centers nothing", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": null, "subkind": { "name": "Primary callout", "slug": "primary", "status": "active", "canonId": "019de52c-fbd1-70eb-a9ce-8997f8674c1d", "version": 1, "description": null }, "framework": null }, "subkind": "primary", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:13:05.964+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "2bdee6b9-0b12-4a86-a78b-8ed3cef7b7d8", "parentComponentId": null }, { "bbox": { "h": 0.03, "w": 0.86, "x": 0.07, "y": 0.52 }, "kind": "callout", "text": "Tsunami of OrganOx and NRP will lead to collapse of TransMedics usage “soon”", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": null, "subkind": { "name": "Primary callout", "slug": "primary", "status": "active", "canonId": "019de52c-fbd1-70eb-a9ce-8997f8674c1d", "version": 1, "description": null }, "framework": null }, "subkind": "primary", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:13:05.964+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "7f0c068b-9203-460f-8940-abde5c9031b8", "parentComponentId": null }, { "bbox": { "h": 0.18, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "paragraph", "text": "The West Coast OPO - which works with some of the highest-volume centers like UCSF, Stanford, and Sutter - stated they are simultaneously kicking off NRP and OrganOx, which they would use on “100% of our DCD donors, which is the bulk of the TransMedics liver machine use” – killing off their TransMedics use completely.", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:13:05.964+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "578d3517-009b-4734-ac1c-2c4f159d8796", "parentComponentId": null }, { "bbox": { "h": 0.25, "w": 0.86, "x": 0.07, "y": 0.25 }, "kind": "paragraph", "text": "Given the dire situation he painted for TransMedics, we asked when the window would close: “you’ll see it happen soon because of all these OPO’s...OrganOx has been having trouble producing the machines in these volume...they’re dropping them at an OPO, at this point, every couple of weeks with us being the second one”; “you want to know why TransMedics is going to blow up?...it’s really liver...most OPO’s I know hate working with them...to the point where’s we’ll all out there getting OrganOx devices...we’re going to do trainings at Stanford, CPMS, and UCSF...and then we’re live.”", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:13:05.964+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "5d02a7bf-4e4f-424f-b5f3-aa882de4a0c2", "parentComponentId": null }, { "bbox": { "h": 0.12, "w": 0.86, "x": 0.07, "y": 0.74 }, "kind": "quote", "text": "“You want to know why TransMedics is going to blow up? You’ve picked up on their heart and lung products have gone nowhere. It’s really liver. Most OPO’s I know hate working with them even though they’re not our vendor, to the point where we’re all out there getting OrganOX devices. We just got ours, and the manufacturer is sending reps out here, and we’re going to go do trainings at Stanford, CPMC, and UCSF. And then we’re live.” – Executive at a West Coast OPO, longtime industry veteran", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:13:05.964+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "395577f5-40f4-4a9f-813c-08b454ef27ed", "parentComponentId": null }, { "bbox": { "h": 0.12, "w": 0.86, "x": 0.07, "y": 0.56 }, "kind": "quote", "text": "Q: “How long do you think the window is? It seems like it’s a fast-approaching wave, like a tsunami between OrganOX and NRP. It sounds to me like UCSF could be at risk, Washington could be at risk, Vanderbilt’s gone away. It seems like wildfire that people are just getting sick of them and are looking for alternatives.” A: “I think you’ll see it happen soon because all of these OPOs, OrganOX has been having trouble producing the machines in these volumes, and it seems like they’re dropping them at an OPO, at this point, every couple of weeks with us being the second one.” – Executive at a West Coast OPO, longtime industry veteran", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:13:05.964+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "d7893cd5-d832-4c1b-ae08-f49b32706821", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "“I think you’ll see it happen soon because all of these OPOs, OrganOX has been having trouble producing the machines in these volumes, and it seems like they’re dropping them at an OPO, at this point, every couple of weeks with us being the second one.” — Executive at a West Coast OPO, longtime industry veteran", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:23+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5374-767b-b3bc-5a7e81d4ae18", "parentComponentId": null }, { "bbox": { "h": 0.02, "w": 0.3, "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:13:05.964+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "f578dacf-1283-4eee-94fb-c5d2ddc2c57c", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [], "arcBeats": [], "loops": [], "locked": true }, { "page": 313, "type": "tension", "title": "The slide uses a direct quote to highlight a competitive threat to TransMedics' business model.", "function": "expose_contradiction", "rawType": "quote_slide", "block": null, "metadata": { "slideType": "quote_slide", "slideTypeCanon": { "name": "Quote slide", "slug": "quote_slide", "status": "active", "canonId": "019de52d-098e-7555-a9fd-4f0af7e80bc2", "version": 1, "description": null }, "function": "expose_contradiction", "functionCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-171f-776f-887c-73edaff4cf9c", "version": 1, "description": null }, "density": "dense", "densityScore": 60, "componentCount": 6, "textChars": 3639, "nDataPoints": 1, "notes": "The slide uses a direct quote to highlight a competitive threat to TransMedics' business model.", "elementsJson": [ "paragraph", "quote_block", "footnote" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:13:05.248+00", "seconds": 9.125, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/313", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-313", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": { "h": 0.03, "w": 0.86, "x": 0.07, "y": 0.51 }, "kind": "callout", "text": "OPO’s aggressively moving to OrganOx; costs transplant centers nothing", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": null, "subkind": { "name": "Primary callout", "slug": "primary", "status": "active", "canonId": "019de52c-fbd1-70eb-a9ce-8997f8674c1d", "version": 1, "description": null }, "framework": null }, "subkind": "primary", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:13:05.248+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "ea7f89da-3e94-475b-81ac-77c99e6701b8", "parentComponentId": null }, { "bbox": null, "kind": "callout", "text": "The West Coast OPO stated that OPO’s are now eliminating the need for centers to use TransMedics, by simply offering OrganOx as a free, back-to-base service near the hospitals they work with", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:24+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5374-767b-b3bd-1784fcdcf88b", "parentComponentId": null }, { "bbox": { "h": 0.43, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "paragraph", "text": "The West Coast OPO stated that OPO’s are now eliminating the need for centers to use TransMedics, by simply offering OrganOx as a free, back-to-base service near the hospitals they work with – and named the largest OPO’s in the country as quickly moving to the same model: “you can pick TransMedics and pay $100,000-plus, plus you’ll for my liver acquisition charge...or you could choose OrganOx normothermic perfusion and it costs you nothing, only the standard acquisition chare....that’s it...that’s all we charge....we’re launching our program...I don’t see why you, as UCSF or any of the transplant centers, would choose to use TransMedics....for any of the Bay Area donors....the group out of LA, the largest OPO in the country, they just received their machine...the OPO in Nevada has received their OrganOx machine...so all of these are going to be owned by the OPO and there is zero additional charge to the transplant center.’", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:13:05.248+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "21a283c6-aad8-4c70-9095-b8a95ab4f230", "parentComponentId": null }, { "bbox": { "h": 0.35, "w": 0.86, "x": 0.07, "y": 0.55 }, "kind": "quote", "text": "“We are paying for that. And if you’re a transplant center in Northern California, and you want normothermic perfusion, you can pick TransMedics and pay $100,000-plus, plus you’ll pay for my liver acquisition charge. Or you could choose OrganOX normothermic perfusion, and it costs you nothing, only the standard acquisition charge. That’s it. That’s all we charge. But we have three machine operators. We have purchased vehicles to move the machine around in. We’re launching our program. I don’t see why you, as UCSF or any of the transplant centers, would choose to use TransMedics over the OrganOX machine for any of the Bay Area donors. There’s another OPO based out of Sacramento; it’s a small group. They received their machine on the [redacted], and they’ll be live on [redacted] The group out of LA, the largest OPO in the country, they just received their machine, and I believe they’re arranging for their training sometime next month and that’s going live. The OPO in Nevada has received their OrganOX machine. So, all of these are going to be owned by the OPO and there is zero additional charge to the transplant center.” – Executive at a West Coast OPO, longtime industry veteran", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:13:05.248+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "ad0957e7-7108-486e-a67a-b08e56d21ae8", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "“We are paying for that. And if you’re a transplant center in Northern California, and you want normothermic perfusion, you can pick TransMedics and pay $100,000-plus, plus you’ll pay for my liver acquisition charge. Or you could choose OrganOX normothermic perfusion, and it costs you nothing, only the standard acquisition charge. That’s it…that’s all we charge. But we have three machine operators. We have purchased vehicles to move the machine around in. We’re launching our program. I don’t see why you, as UCSF or any of the transplant centers, would choose to use TransMedics over the OrganOX machine for any of the Bay Area donors. There’s another OPO based out of Sacramento; it’s a small group. They received their machine on the [redacted], and they’ll be live on [redacted] The group out of LA, the largest OPO in the country, they just received their machine, and I believe they’re arranging for their training sometime next month and that’s going live. The OPO in Nevada has received their OrganOX machine. So, all of these are going to be owned by the OPO and there is zero additional charge to the transplant center.” — Executive at a West Coast OPO, longtime industry veteran", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:24+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5374-767b-b3bd-193accfab99b", "parentComponentId": null }, { "bbox": { "h": 0.02, "w": 0.3, "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:13:05.248+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "2e8ab4b7-cf02-4a7e-8692-32fe374348d3", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [], "arcBeats": [], "loops": [], "locked": true }, { "page": 314, "type": "evidence", "title": "The slide uses direct quotes from an organ procurement specialist to validate the thesis of market disruption.", "function": "illustrate_case", "rawType": "testimonial", "block": null, "metadata": { "slideType": "testimonial", "slideTypeCanon": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52d-0a2d-7782-8a48-7e84df92cc97", "version": 1, "description": null }, "function": "illustrate_case", "functionCanon": { "name": "Illustrate case", "slug": "illustrate_case", "status": "active", "canonId": "019de52d-13b4-772c-bb73-1873612a7463", "version": 1, "description": null }, "density": "dense", "densityScore": 53, "componentCount": 7, "textChars": 1197, "nDataPoints": 1, "notes": "The slide uses direct quotes from an organ procurement specialist to validate the thesis of market disruption.", "elementsJson": [ "paragraph", "callout_box", "footnote" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:13:04.913+00", "seconds": 8.623, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/314", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-314", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "Paragonix is just cold static storage but they maintain a temperature between 4 and 8 degrees, they’re not freezing and they’re maintaining them at these ideal temperatures.", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:24+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5374-767b-b3bc-feeaf7a3b3fc", "parentComponentId": null }, { "bbox": { "h": 0.32, "w": 0.86, "x": 0.07, "y": 0.16 }, "kind": "paragraph", "text": "An organ retrieval specialist at a Northwest academic transplant center, who travels to operating rooms across the US, indicated rapid uptake of the devices in cases which previously used TransMedics...", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:13:04.913+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "607e2bb6-ffbe-40be-8926-b98f79bfc51d", "parentComponentId": null }, { "bbox": { "h": 0.18, "w": 0.86, "x": 0.07, "y": 0.51 }, "kind": "quote", "text": "Paragonix already taking TransMedics market share; only $10-20K. The Paragonix devices are changing the whole...", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:13:04.913+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "b7a35bae-6259-403a-8dce-d9b9d2b3d590", "parentComponentId": null }, { "bbox": { "h": 0.21, "w": 0.86, "x": 0.07, "y": 0.72 }, "kind": "quote", "text": "Paragonix liver “taking off like crazy”; for long-haul transport as well. I mean, we would never have seen lungs come from the East Coast with a Paragonix device prior to this...", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:13:04.913+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "eaa4d4ed-3aa4-438f-a3e9-bd8cde38ce59", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "“The Paragonix devices are changing the whole - I was in the operating room the other day - Mass General, was getting lungs from California, in a Paragonix. And typically, that would have only been TransMedics a couple of years ago. but they’re changing the game.” — Organ procurement specialist at a Northwest academic transplant center", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:24+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5374-767b-b3bd-03687fce4541", "parentComponentId": null }, { "bbox": { "h": 0.03, "w": 0.3, "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:13:04.913+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "8e283e58-60b3-49f4-838d-109d818174a8", "parentComponentId": null }, { "bbox": { "h": 0.08, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "title", "text": "Paragonix, a hypothermic preservation system for the heart, lung, and liver that costs only $10-$20K, is also disrupting TransMedics usage.", "attrs": null, "canon": { "kind": { "name": "Title", "slug": "title", "status": "active", "canonId": "019de52c-f7dd-76d9-b848-b1f12bd85cf4", "version": 1, "description": "Slide title or headline." }, "tool": null, "subkind": { "name": "Headline", "slug": "headline", "status": "active", "canonId": "019de52c-fae1-7463-9a7c-d60668eced0d", "version": 1, "description": null }, "framework": null }, "subkind": "headline", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:13:04.913+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "e738dbbc-8989-4fd1-b264-6ab779b47125", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [], "arcBeats": [], "loops": [], "locked": true }, { "page": 315, "type": "tension", "title": "The slide uses direct quotes from a transplant surgeon to validate the thesis that TransMedics is at risk of being rendered obsolete by competitors.", "function": "expose_gap", "rawType": "testimonial", "block": null, "metadata": { "slideType": "testimonial", "slideTypeCanon": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52d-0a2d-7782-8a48-7e84df92cc97", "version": 1, "description": null }, "function": "expose_gap", "functionCanon": { "name": "Expose gap", "slug": "expose_gap", "status": "active", "canonId": "019de52d-1795-772d-8f3a-75ccfb93fe58", "version": 1, "description": null }, "density": "dense", "densityScore": 55, "componentCount": 6, "textChars": 2033, "nDataPoints": 1, "notes": "The slide uses direct quotes from a transplant surgeon to validate the thesis that TransMedics is at risk of being rendered obsolete by competitors.", "elementsJson": [ "paragraph", "quote_block", "callout_box" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:13:03.88+00", "seconds": 7.551, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/315", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-315", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "LifePort is a key threat to TransMedics", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:24+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5374-767b-b3bc-d189f92fbe3e", "parentComponentId": null }, { "bbox": { "h": 0.45, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "paragraph", "text": "A leading transplant surgeon and KOL stated that OrganOx and Paragonix are merely the tip of the iceberg, with a second wave of devices in trials that will render TransMedics obsolete. The surgeon participated in TransMedics studies and interacts with management, offering an “inside baseball” view of the centers/investigators now conducting competing trials and stated that LifePort’s Liver Transporter is a critical threat, given its kidney device has a lock with 90% share, surgeon excitement for its liver data, and TransMedics alienation of surgeons: “the real competition based on everything I know of the Columbia Presbyterian data...is LifePort...centers I think are really good...are on board with the LifePort study...TransMedics did this hard sell, push down your throat approach to the surgical community...a lot of people they pissed off...people who would say I’m using LifePort because it’s not TransMedics; “we have no loyalty whatsoever to TransMedics...they are at real risk...LifePort is going to be very, very competitive and may exceed the interest level” for TransMedics.", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:13:03.88+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "2d8cfccd-6691-4649-9597-9eaa4e707170", "parentComponentId": null }, { "bbox": { "h": 0.15, "w": 0.86, "x": 0.07, "y": 0.78 }, "kind": "quote", "text": "LifePort will be “very, very competitive” and surgeons “have no loyalty whatsoever to TransMedics”\n“If LifePort’s trial and subsequent FDA approval show that you can get more information... we have no brand whatsoever to TransMedics...”", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:13:03.88+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "8d03b5d7-1a76-4363-8bb2-14dac6ad6df2", "parentComponentId": null }, { "bbox": { "h": 0.2, "w": 0.86, "x": 0.07, "y": 0.55 }, "kind": "quote", "text": "LifePort is a key threat to TransMedics\n“The real competition based on everything I know of the Columbia Presbyterian data, and I know James Guarrera, who is the lead investigator for that, is LifePort...\"", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:13:03.88+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "9c48b24a-0654-40d1-94bd-ae58d00de95a", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "\"The real competition based on everything I know of the Columbia Presbyterian data, and I know James Guarrera, who is the lead investigator for that, is LifePort... TransMedics did this hard sell, push down your throat approach to the surgical community... people who would say I’m using LifePort just because it’s not TransMedics.\" — Transplant surgeon, Director of a leading academic transplant center", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:24+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5374-767b-b3bc-d54071871301", "parentComponentId": null }, { "bbox": { "h": 0.03, "w": 0.3, "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:13:03.88+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "287b6e9a-832f-47a0-b281-680828689f75", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [ { "matchId": "8578421f-37ef-49dd-be5c-d46aa3aa869a", "evidence": "Uses KOL/Surgeon testimony to validate competitive threat", "framework": null, "confidence": 0.9, "extraction": { "at": "2026-05-02 20:13:03.88+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 315, "frameworkName": "authority-citation" } ], "arcBeats": [], "loops": [], "locked": true }, { "page": 316, "type": "tension", "title": "Includes verbatim transcripts from a transplant surgeon regarding competitive dynamics in the liver transplant market.", "function": "expose_contradiction", "rawType": "quote_slide", "block": null, "metadata": { "slideType": "quote_slide", "slideTypeCanon": { "name": "Quote slide", "slug": "quote_slide", "status": "active", "canonId": "019de52d-098e-7555-a9fd-4f0af7e80bc2", "version": 1, "description": null }, "function": "expose_contradiction", "functionCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-171f-776f-887c-73edaff4cf9c", "version": 1, "description": null }, "density": "dense", "densityScore": 55, "componentCount": 7, "textChars": 1223, "nDataPoints": 3, "notes": "Includes verbatim transcripts from a transplant surgeon regarding competitive dynamics in the liver transplant market.", "elementsJson": [ "paragraph", "quote_block", "footnote" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:13:03.665+00", "seconds": 7.308, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/316", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-316", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "Top liver centers who were involved with TransMedics have defected to LifePort", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:24+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5374-767b-b3bd-2d109e4b94b7", "parentComponentId": null }, { "bbox": { "h": 0.1, "w": 0.86, "x": 0.07, "y": 0.22 }, "kind": "paragraph", "text": "In addition, he pointed to VitaSmart’s hypothermic system which uses a temperature of 4 to 12 degrees Celsius to reduce an organ’s metabolic rate to 10% of normal and prevents re-perfusion injury common with TransMedics pump.", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:13:03.665+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "016d7e9d-b411-4fd9-b57e-398bd6df2081", "parentComponentId": null }, { "bbox": { "h": 0.18, "w": 0.86, "x": 0.07, "y": 0.72 }, "kind": "quote", "text": "The study that was the basis of the FDA submission for TransMedics for their liver approval was JAMA surgery in 2022... The decreases in EAD were fairly equivalent, which surprised a lot of people...", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:13:03.665+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "38356584-f728-4d0d-a85a-4e53bef30a39", "parentComponentId": null }, { "bbox": { "h": 0.15, "w": 0.86, "x": 0.07, "y": 0.5 }, "kind": "quote", "text": "The LifePort study is a really good example. These are centers; some were in the TransMedics trial, but they clearly jumped ship to be involved with LifePort...", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:13:03.665+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "77980717-cad5-4f45-88da-dcca64ed6cdc", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "“The LifePort study is a really good example. These are centers; some were in the TransMedics trial, but they clearly jumped ship to be involved with LifePort...that’s the device that a lot of really big names in the field in liver really think is going to be very, very competitive with TransMedics” — Transplant surgeon, Director of a leading academic transplant center", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:24+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5374-767b-b3bd-33338d3e8649", "parentComponentId": null }, { "bbox": { "h": 0.03, "w": 0.3, "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:13:03.665+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "2434d346-f9d1-42d9-ac98-b371527aeddd", "parentComponentId": null }, { "bbox": { "h": 0.15, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "title", "text": "The KOL stated that top liver centers – “really big names in the field” – from the TransMedics trial have already defected to LifePort", "attrs": null, "canon": { "kind": { "name": "Title", "slug": "title", "status": "active", "canonId": "019de52c-f7dd-76d9-b848-b1f12bd85cf4", "version": 1, "description": "Slide title or headline." }, "tool": null, "subkind": { "name": "Headline", "slug": "headline", "status": "active", "canonId": "019de52c-fae1-7463-9a7c-d60668eced0d", "version": 1, "description": null }, "framework": null }, "subkind": "headline", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:13:03.665+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "5912d1fa-9172-49a6-b69b-d5c6dd732d15", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [ { "matchId": "d09578ae-b2aa-4c73-9cb2-bac66c2a206d", "evidence": "Use of KOL (Key Opinion Leader) quotes to validate competitive claims.", "framework": null, "confidence": 0.9, "extraction": { "at": "2026-05-02 20:13:03.665+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 316, "frameworkName": "authority-citation" } ], "arcBeats": [], "loops": [], "locked": true }, { "page": 317, "type": "tension", "function": "frame_problem", "rawType": "thesis_headline", "block": null, "metadata": { "slideType": "thesis_headline", "slideTypeCanon": { "name": "Thesis headline", "slug": "thesis_headline", "status": "active", "canonId": "019de52d-073a-70cb-b9f6-772a597bb5af", "version": 1, "description": null }, "function": "frame_problem", "functionCanon": { "name": "Frame problem", "slug": "frame_problem", "status": "active", "canonId": "019de52d-13db-753e-ad70-e9b2d0dab398", "version": 1, "description": null }, "density": "sparse", "densityScore": 9, "componentCount": 2, "textChars": 441, "nDataPoints": 0, "notes": null, "elementsJson": [ "headline_text" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:13:07.217+00", "seconds": 10.85, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/317", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-317", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "OPO’s and transplant centers are standardizing around an inexpensive, alternative technique which has long been the standard of care in Europe, with TransMedics 2025 revenue at risk of collapse.", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:23+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5374-767b-b3bc-848f54702ae0", "parentComponentId": null }, { "bbox": { "h": 0.155, "w": 0.854, "x": 0.073, "y": 0.07 }, "kind": "title", "text": "Part 14. Disruption by NRP, spreading like wildfire. OPO’s and transplant centers are standardizing around an inexpensive, alternative technique which has long been the standard of care in Europe, with TransMedics 2025 revenue at risk of collapse.", "attrs": null, "canon": { "kind": { "name": "Title", "slug": "title", "status": "active", "canonId": "019de52c-f7dd-76d9-b848-b1f12bd85cf4", "version": 1, "description": "Slide title or headline." }, "tool": null, "subkind": { "name": "Headline", "slug": "headline", "status": "active", "canonId": "019de52c-fae1-7463-9a7c-d60668eced0d", "version": 1, "description": null }, "framework": null }, "subkind": "headline", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:13:07.217+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "d52f58b0-a5f9-4bf2-8f39-e3cdc370abb6", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [], "arcBeats": [], "loops": [], "locked": true }, { "page": 318, "type": "tension", "title": "The slide uses a combination of cost comparison and technical diagrams to argue for the obsolescence of the subject company's core product.", "function": "expose_gap", "rawType": "villain_critique", "block": null, "metadata": { "slideType": "villain_critique", "slideTypeCanon": { "name": "Villain critique", "slug": "villain_critique", "status": "active", "canonId": "019de52d-10bc-7136-bf20-09de59d17447", "version": 1, "description": null }, "function": "expose_gap", "functionCanon": { "name": "Expose gap", "slug": "expose_gap", "status": "active", "canonId": "019de52d-1795-772d-8f3a-75ccfb93fe58", "version": 1, "description": null }, "density": "balanced", "densityScore": 49, "componentCount": 7, "textChars": 888, "nDataPoints": 6, "notes": "The slide uses a combination of cost comparison and technical diagrams to argue for the obsolescence of the subject company's core product.", "elementsJson": [ "paragraph", "headline_text", "screenshot", "process_diagram", "footnote" ], "confidence": 0.95, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:13:05.213+00", "seconds": 8.677, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/318", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-318", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "The recent explosion of normothermic regional perfusion (NRP) – an inexpensive way to retrieve DCD organs, the entire use case for TransMedics and driver of its growth – renders TransMedics essentially obsolete, given NRP is $3,000 per case versus $80-90K for OCS plus another $40-100K or more for its NOP procurement service.", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:24+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5374-767b-b3bd-454599d85e3c", "parentComponentId": null }, { "bbox": { "h": 0.35, "w": 0.38, "x": 0.55, "y": 0.58 }, "kind": "image", "text": "Diagram of NRP circuit in human body", "attrs": null, "canon": { "kind": { "name": "Image", "slug": "image", "status": "active", "canonId": "019de52c-f978-701f-a720-51d029d769e7", "version": 1, "description": "Photo, illustration, screenshot or icon." }, "tool": null, "subkind": { "name": "Illustration", "slug": "illustration", "status": "active", "canonId": "019de52c-fe76-7772-a5ac-c0b7294d7615", "version": 1, "description": null }, "framework": null }, "subkind": "illustration", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:13:05.213+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "eed67531-9c03-4e18-826e-12bf9b12cdbf", "parentComponentId": null }, { "bbox": { "h": 0.35, "w": 0.45, "x": 0.07, "y": 0.58 }, "kind": "image", "text": "Photo of NRP equipment setup with labels", "attrs": null, "canon": { "kind": { "name": "Image", "slug": "image", "status": "active", "canonId": "019de52c-f978-701f-a720-51d029d769e7", "version": 1, "description": "Photo, illustration, screenshot or icon." }, "tool": null, "subkind": { "name": "Infographic", "slug": "infographic", "status": "active", "canonId": "019de52c-fe26-750c-9d7d-9f34e21324e8", "version": 1, "description": null }, "framework": null }, "subkind": "infographic", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:13:05.213+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "e5428903-0d2b-4437-b3f1-40c3a15be9f0", "parentComponentId": null }, { "bbox": null, "kind": "metric", "text": "cost per case: $3,000", "attrs": null, "canon": { "kind": { "name": "Metric", "slug": "metric", "status": "active", "canonId": "019de52c-f923-73bf-8081-d0b1a8c5264d", "version": 1, "description": "Big-number or KPI value." }, "tool": { "name": "Quantification", "slug": "quantification", "status": "active", "bestFor": null, "canonId": "019dd9e1-47ab-72ce-a079-aab1f5299e88", "version": 1, "bodyDocId": null, "description": "Translating a claim into numbers, charts, or tables.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": "primary", "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:24+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5374-767b-b3bd-4b215bafb741", "parentComponentId": null }, { "bbox": { "h": 0.45, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "paragraph", "text": "The recent explosion of normothermic regional perfusion (NRP) – an inexpensive way to retrieve DCD organs, the entire use case for TransMedics and driver of its growth – renders TransMedics essentially obsolete...", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:13:05.213+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "de382168-ac49-4e43-88c8-4cbbb5122715", "parentComponentId": null }, { "bbox": { "h": 0.04, "w": 0.65, "x": 0.07, "y": 0.94 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts; https://www.researchgate.net/figure/ECMO-setup-for-cDCD_fig1_325783357; https://www.jtcvstechniques.org/article/S2666-2507%2823%292900374-7/fulltext", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:13:05.213+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "c1ff1da7-9879-4eee-9ac5-e947f81b07f6", "parentComponentId": null }, { "bbox": { "h": 0.03, "w": 0.35, "x": 0.07, "y": 0.54 }, "kind": "title", "text": "Examples of cardiac and abdominal NRP circuits", "attrs": null, "canon": { "kind": { "name": "Title", "slug": "title", "status": "active", "canonId": "019de52c-f7dd-76d9-b848-b1f12bd85cf4", "version": 1, "description": "Slide title or headline." }, "tool": null, "subkind": { "name": "Headline", "slug": "headline", "status": "active", "canonId": "019de52c-fae1-7463-9a7c-d60668eced0d", "version": 1, "description": null }, "framework": null }, "subkind": "headline", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:13:05.213+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "25968623-dcbc-4059-a7b3-661524ee5192", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [ { "matchId": "fe0406c2-15c3-4a63-9dd8-dd860cd31b69", "evidence": "The slide explicitly frames TransMedics as obsolete due to a cheaper, more effective alternative.", "framework": null, "confidence": 0.9, "extraction": { "at": "2026-05-02 20:13:05.213+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 318, "frameworkName": "villain-critique" } ], "arcBeats": [], "loops": [], "locked": true }, { "page": 319, "type": "tension", "title": "The slide uses expert testimony to frame TransMedics as an overpriced incumbent being disrupted by a cheaper, established European technique (NRP).", "function": "name_villain", "rawType": "villain_critique", "block": null, "metadata": { "slideType": "villain_critique", "slideTypeCanon": { "name": "Villain critique", "slug": "villain_critique", "status": "active", "canonId": "019de52d-10bc-7136-bf20-09de59d17447", "version": 1, "description": null }, "function": "name_villain", "functionCanon": { "name": "Name villain", "slug": "name_villain", "status": "active", "canonId": "019de52d-1746-70d6-bc58-5eeaf5865526", "version": 1, "description": null }, "density": "dense", "densityScore": 53, "componentCount": 6, "textChars": 1537, "nDataPoints": 6, "notes": "The slide uses expert testimony to frame TransMedics as an overpriced incumbent being disrupted by a cheaper, established European technique (NRP).", "elementsJson": [ "paragraph", "quote_block" ], "confidence": 0.95, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:13:07.895+00", "seconds": 11.229, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/319", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-319", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "TransMedics cost is ridiculously high.", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:24+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5374-767b-b3bc-e4a2f7ab34ee", "parentComponentId": null }, { "bbox": { "h": 0.45, "w": 0.86, "x": 0.07, "y": 0.45 }, "kind": "list", "text": "NRP used in Europe for 20 years; Vanderbilt was the pioneer in US. Vanderbilt NRP usage has crushed use of TransMedics. NRP is 3% of TransMedics device cost.", "attrs": null, "canon": { "kind": { "name": "List", "slug": "list", "status": "active", "canonId": "019de52c-f94b-779b-a53b-fd4904a5f4d2", "version": 1, "description": "Bullet or numbered list." }, "tool": null, "subkind": { "name": "Bullet list", "slug": "bullet", "status": "active", "canonId": "019de52c-fc98-7169-a083-5cab805076ca", "version": 1, "description": null }, "framework": null }, "subkind": "bullet", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:13:07.895+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "ff917cee-6ed1-4304-beb7-0ba234bbf30d", "parentComponentId": null }, { "bbox": null, "kind": "metric", "text": "cost: $3,000", "attrs": null, "canon": { "kind": { "name": "Metric", "slug": "metric", "status": "active", "canonId": "019de52c-f923-73bf-8081-d0b1a8c5264d", "version": 1, "description": "Big-number or KPI value." }, "tool": { "name": "Quantification", "slug": "quantification", "status": "active", "bestFor": null, "canonId": "019dd9e1-47ab-72ce-a079-aab1f5299e88", "version": 1, "bodyDocId": null, "description": "Translating a claim into numbers, charts, or tables.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": "primary", "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:24+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5374-767b-b3bc-ede839185791", "parentComponentId": null }, { "bbox": { "h": 0.35, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "paragraph", "text": "Vanderbilt University – a transplant pioneer and perhaps the highest-volume center globally – also pioneered the use of NRP in the US, for both heart and liver. A transplant surgeon in a leadership role stated that NRP has now wiped out almost 100% of their use of TransMedics devices for both liver and heart – “it has been done in Europe for 20 years...over the last two years, Vanderbilt was the pioneer in using this technique” in the US. He stated they do 200 liver transplants a year, with TransMedics use now down to just 10 cases – “for each organ that you recover with TransMedics, it’s almost $100,000. NRP is $3,000, and with $3,000 you can recover the heart, lung, liver, kidney, and pancreas...so $3,000 versus $300,000 if you want to recover all the organs. TransMedics cost is ridiculously high.”", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:13:07.895+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "a1509be6-2d68-443b-abe4-64689e22cd5d", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "\"it has been done in Europe for 20 years...over the last two years, Vanderbilt was the pioneer in using this technique\" — Transplant surgeon at Vanderbilt. \"For each organ that you recover with TransMedics, it’s almost $100,000. NRP is $3,000, and with $3,000 you can recover the heart, lung, liver, kidney, and pancreas...so $3,000 versus $300,000 if you want to recover all the organs. TransMedics cost is ridiculously high.\" — Transplant surgeon at Vanderbilt.", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:24+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5374-767b-b3bc-eb9bca3b9105", "parentComponentId": null }, { "bbox": { "h": 0.03, "w": 0.25, "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:13:07.895+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "99d39ce8-c092-4b03-8b50-695f63b473d7", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [ { "matchId": "449bf090-0547-4873-b510-d5cf83e7be16", "evidence": "Frames TransMedics as the 'ridiculously high' cost villain compared to the efficient NRP technique.", "framework": null, "confidence": 0.9, "extraction": { "at": "2026-05-02 20:13:07.895+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 319, "frameworkName": "antagonist-introduction" } ], "arcBeats": [], "loops": [], "locked": true }, { "page": 320, "type": "tension", "title": "The slide uses direct quotes from a consultation call to highlight the competitive threat of NRP to TransMedics.", "function": "expose_contradiction", "rawType": "testimonial", "block": null, "metadata": { "slideType": "testimonial", "slideTypeCanon": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52d-0a2d-7782-8a48-7e84df92cc97", "version": 1, "description": null }, "function": "expose_contradiction", "functionCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-171f-776f-887c-73edaff4cf9c", "version": 1, "description": null }, "density": "dense", "densityScore": 74, "componentCount": 8, "textChars": 2492, "nDataPoints": 3, "notes": "The slide uses direct quotes from a consultation call to highlight the competitive threat of NRP to TransMedics.", "elementsJson": [ "paragraph", "footnote" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:13:05.651+00", "seconds": 8.548, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/320", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-320", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "TransMedics speaks a lot of garbage about NRP...they talk trash because it’s a big competitor and way cheaper.", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:25+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5374-767b-b3bd-88c46988af6e", "parentComponentId": null }, { "bbox": { "h": 0.02, "w": 0.45, "x": 0.07, "y": 0.41 }, "kind": "list", "text": "OPO’s trained to do NRP’s almost exclusively vs. TransMedics", "attrs": null, "canon": { "kind": { "name": "List", "slug": "list", "status": "active", "canonId": "019de52c-f94b-779b-a53b-fd4904a5f4d2", "version": 1, "description": "Bullet or numbered list." }, "tool": null, "subkind": { "name": "Bullet list", "slug": "bullet", "status": "active", "canonId": "019de52c-fc98-7169-a083-5cab805076ca", "version": 1, "description": null }, "framework": null }, "subkind": "bullet", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:13:05.651+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "2c8c3d00-0bd1-4666-87c9-8f4db2b14d87", "parentComponentId": null }, { "bbox": { "h": 0.02, "w": 0.35, "x": 0.07, "y": 0.61 }, "kind": "list", "text": "NRP is so inexpensive “it is insane”", "attrs": null, "canon": { "kind": { "name": "List", "slug": "list", "status": "active", "canonId": "019de52c-f94b-779b-a53b-fd4904a5f4d2", "version": 1, "description": "Bullet or numbered list." }, "tool": null, "subkind": { "name": "Bullet list", "slug": "bullet", "status": "active", "canonId": "019de52c-fc98-7169-a083-5cab805076ca", "version": 1, "description": null }, "framework": null }, "subkind": "bullet", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:13:05.651+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "a3bcd9f6-beee-4497-a1d2-0b2ef5742a6f", "parentComponentId": null }, { "bbox": { "h": 0.28, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "paragraph", "text": "He stated that the only that the cost savings versus TransMedics “is insane…that’s the reason we do NRP so much…you can get one of these pumps for $1,000…it’s very cheap.” He stated their local OPO is now standardized on NRP, eliminating the use of pumps like TransMedics: “our OPO is Tennessee Donor Service…they do NRP on every single DCD…we never use machine perfusion…our OPO has their own surgeon…the surgeon is recovering all of the organs via NRP.” The surgeon added that TransMedics badmouths NRP because they know it’s a serious threat: “TransMedics speaks a lot of garbage about NRP…they talk trash because it’s a big competitor and way cheaper.”", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:13:05.651+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "74103940-5dc5-4818-b94f-fbba4a2c50d3", "parentComponentId": null }, { "bbox": { "h": 0.22, "w": 0.86, "x": 0.07, "y": 0.64 }, "kind": "quote", "text": "A: “To do NRP, the main thing that you need is you need a perfusionist because you need to bring a little pump with you. It’s a portable pump; it’s very cheap. You can get one of these pumps for $1, 000, and this is disposable; it’s very cheap. You have to go with this little pump with a perfusionist, so then you can put the donor on this extracorporeal circulation during the recovery of the organ.” Q: “There’s literally a $1000 device and a total cost of $3000 versus $100,000.” A: “It is insane. And that’s the reason that we do NRP that much. That’s the main reason….TransMedics speaks a lot of garbage about NRP. They talk trash because it’s a big competitor and way cheaper. And more and more and more centers are using NRP now.” – Transplant surgeon at Vanderbilt", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:13:05.651+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "8a6eab9d-f660-4d2d-b516-19f8db0b3465", "parentComponentId": null }, { "bbox": { "h": 0.15, "w": 0.86, "x": 0.07, "y": 0.44 }, "kind": "quote", "text": "A: “Our OPO is Tennessee Donor Service in our area. So, they do NRP on every single DCD. So, every time that we have a DCD, our OPO will always use NRP. We never use machine perfusion. But when we have to recover a DCD in a different area, in those cases, we use TransMedics. Those are the 10% cases that we do per year. They are done outside Vanderbilt.” Q: “So, you trained your OPO in NRP, basically?” A: “Yes, we did. Our OPO has their own surgeon, and the surgeon is recovering all of the organs via NRP. So, our OPO, they do all NRPs.” – Transplant surgeon at Vanderbilt", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:13:05.651+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "9540f170-3ffb-4826-8a84-49ad66d212a4", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "“Our OPO is Tennessee Donor Service...they do NRP on every single DCD...we never use machine perfusion...our OPO has their own surgeon...the surgeon is recovering all of the organs via NRP.” — Transplant surgeon at Vanderbilt", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:25+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5374-767b-b3bd-8e54f1e4e6fc", "parentComponentId": null }, { "bbox": { "h": 0.02, "w": 0.3, "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:13:05.651+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "319e9283-9d4a-493f-b1b2-62ccedacf53c", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [], "arcBeats": [], "loops": [], "locked": true }, { "page": 321, "type": "resolution", "title": "Includes citations from JAMA and American Journal of Transplantation.", "function": "summarize", "rawType": "key_takeaways", "block": null, "metadata": { "slideType": "key_takeaways", "slideTypeCanon": { "name": "Key takeaways", "slug": "key_takeaways", "status": "active", "canonId": "019de52d-06e7-7674-a891-9f7de3b11b6d", "version": 1, "description": null }, "function": "summarize", "functionCanon": { "name": "Summarize", "slug": "summarize", "status": "active", "canonId": "019de52d-1541-704f-b86f-bf7b75056373", "version": 1, "description": null }, "density": "balanced", "densityScore": 39, "componentCount": 5, "textChars": 1087, "nDataPoints": 4, "notes": "Includes citations from JAMA and American Journal of Transplantation.", "elementsJson": [ "paragraph", "callout_box", "screenshot", "data_table" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:13:08.203+00", "seconds": 11.069, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/321", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-321", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": { "h": 0.35, "w": 0.43, "x": 0.5, "y": 0.49 }, "kind": "image", "text": "American Journal of Transplantation article snippet and table", "attrs": null, "canon": { "kind": { "name": "Image", "slug": "image", "status": "active", "canonId": "019de52c-f978-701f-a720-51d029d769e7", "version": 1, "description": "Photo, illustration, screenshot or icon." }, "tool": null, "subkind": { "name": "Screenshot", "slug": "screenshot", "status": "active", "canonId": "019de52c-fd87-7509-8391-3d79fb339379", "version": 1, "description": null }, "framework": null }, "subkind": "screenshot", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:13:08.203+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "c110826a-4ae2-420e-8dd6-a07e2a052f7a", "parentComponentId": null }, { "bbox": { "h": 0.35, "w": 0.43, "x": 0.07, "y": 0.49 }, "kind": "image", "text": "JAMA article snippet", "attrs": null, "canon": { "kind": { "name": "Image", "slug": "image", "status": "active", "canonId": "019de52c-f978-701f-a720-51d029d769e7", "version": 1, "description": "Photo, illustration, screenshot or icon." }, "tool": null, "subkind": { "name": "Screenshot", "slug": "screenshot", "status": "active", "canonId": "019de52c-fd87-7509-8391-3d79fb339379", "version": 1, "description": null }, "framework": null }, "subkind": "screenshot", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:13:08.203+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "da46dc53-039c-489a-aa47-5dfe855a81a1", "parentComponentId": null }, { "bbox": { "h": 0.38, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "paragraph", "text": "Our interviews indicate that OPO's and transplant centers large and small have now begin aggressively rolling out NRP. An Oct 24, 2024 paper just published in JAMA surveyed 55 of the 57 OPO's in the US to gauge their rate of adoption – 49 indicated they already have experience with the technique, indicating it is on the cusp of becoming the standard of care as it is in Europe. Transplant surgeons pointed to enthusiasm and buzz around other recent conference presentations and published papers, showing extraordinary cost savings versus TransMedics-types pumps as well as superior outcomes – such as another Oct 2024 paper in the American Journal of Transplantation showing an all-in cost labor and consumables of $9,000 per organ with NRP vs. $80,000 for machine perfusion.", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:13:08.203+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "4164269e-24e8-4087-a58c-f13ce3e8f2e7", "parentComponentId": null }, { "bbox": { "h": 0.04, "w": 0.45, "x": 0.07, "y": 0.94 }, "kind": "source-note", "text": "Source: https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2825303; https://www.amjtransplant.org/article/S1600-6135(24)00237-5/abstract", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:13:08.203+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "0694d420-1000-4cda-935b-bc137b8152b7", "parentComponentId": null }, { "bbox": { "h": 0.04, "w": 0.86, "x": 0.07, "y": 0.44 }, "kind": "title", "text": "Two Oct 2024 papers: rapid adoption and cost savings from NRP vs. machine perfusion", "attrs": null, "canon": { "kind": { "name": "Title", "slug": "title", "status": "active", "canonId": "019de52c-f7dd-76d9-b848-b1f12bd85cf4", "version": 1, "description": "Slide title or headline." }, "tool": null, "subkind": { "name": "Action title", "slug": "action-title", "status": "active", "canonId": "019de52c-fb31-734c-a0f5-a3935b73135d", "version": 1, "description": null }, "framework": null }, "subkind": "action-title", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:13:08.203+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "f6881728-b18a-4459-9231-154b64bfe8aa", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [], "arcBeats": [], "loops": [], "locked": true }, { "page": 322, "type": "tension", "title": "The slide contrasts the perceived limitations of TransMedics' technology with the functional advantages of NRP, supported by expert testimony and market evidenc", "function": "expose_contradiction", "rawType": "expose_contradiction", "block": null, "metadata": { "slideType": "expose_contradiction", "slideTypeCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-124c-75aa-984a-0a3d0d8fc8df", "version": 1, "description": null }, "function": "expose_contradiction", "functionCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-171f-776f-887c-73edaff4cf9c", "version": 1, "description": null }, "density": "dense", "densityScore": 51, "componentCount": 6, "textChars": 2122, "nDataPoints": 0, "notes": "The slide contrasts the perceived limitations of TransMedics' technology with the functional advantages of NRP, supported by expert testimony and market evidence.", "elementsJson": [ "paragraph", "screenshot" ], "confidence": 0.95, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:13:04.2+00", "seconds": 7.023, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/322", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-322", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "Unsurprisingly, OPO's and centers are flocking to NRP, either training their own staff or contracting with inexpensive, third-party NRP perfusion services which are proliferating – and marketing via Google ads.", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:25+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5374-767b-b3bd-a3b041671ced", "parentComponentId": null }, { "bbox": { "h": 0.33, "w": 0.86, "x": 0.07, "y": 0.59 }, "kind": "image", "text": "Google search results for NRP services", "attrs": null, "canon": { "kind": { "name": "Image", "slug": "image", "status": "active", "canonId": "019de52c-f978-701f-a720-51d029d769e7", "version": 1, "description": "Photo, illustration, screenshot or icon." }, "tool": null, "subkind": { "name": "Screenshot", "slug": "screenshot", "status": "active", "canonId": "019de52c-fd87-7509-8391-3d79fb339379", "version": 1, "description": null }, "framework": null }, "subkind": "screenshot", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:13:04.2+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "13e30498-53ed-4836-bd6c-16d7dfdd9214", "parentComponentId": null }, { "bbox": { "h": 0.45, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "paragraph", "text": "Ww earlier quoted various surgeons who indicated that NRP is not only radically cheaper but that it enables better organ assessment and preservation as the organs are still inside the donor – “there’s no alternative other than NRP, really”: “the heart on the TransMedics device is beating but it’s empty...it’s not supporting circulation...it’s not generating a pressure...you’re guessing”; “there are limitations in terms of the actual assessment of the heart on that device...it’s not the most robust test of organ quality...there’s no way to assess it...with a TransMedics device, there is no resistance...if you resuscitate with NRP...you can actually have a clear assessment...that’s missing on the TransMedics device: true functional assessment of this organ...if it looks good on the machine, will it look good once you put it in.” Unsurprisingly, OPO’s and centers are flocking to NRP, either training their own staff or contracting with inexpensive, third-party NRP perfusion services which are proliferating – and marketing via Google ads.", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:13:04.2+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "30ee9a2a-dc5b-459d-b1e9-9a0a839c9d7f", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "“there’s no alternative other than NRP, really”: “the heart on the TransMedics device is beating but it’s empty...it’s not supporting circulation...it’s not generating a pressure...you’re guessing”; “there are limitations in terms of the actual assessment of the heart on that device...it’s not the most robust test of organ quality...there’s no way to assess it...with a TransMedics device, there is no resistance...if you resuscitate with NRP...you can actually have a clear assessment...that’s missing on the TransMedics device: true functional assessment of this organ...if it looks good on the machine, will it look good once you put it in.” — Various Surgeons", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:25+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5374-767b-b3bd-a7561b4d05e3", "parentComponentId": null }, { "bbox": { "h": 0.02, "w": 0.5, "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts; https://keystoneperfusion.com/; Google search", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:13:04.2+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "e3a37f0e-a4f0-448b-85e1-8d1b84bb56c8", "parentComponentId": null }, { "bbox": { "h": 0.03, "w": 0.5, "x": 0.07, "y": 0.54 }, "kind": "title", "text": "Google ads for third-party NRP services; example provider", "attrs": null, "canon": { "kind": { "name": "Title", "slug": "title", "status": "active", "canonId": "019de52c-f7dd-76d9-b848-b1f12bd85cf4", "version": 1, "description": "Slide title or headline." }, "tool": null, "subkind": { "name": "Headline", "slug": "headline", "status": "active", "canonId": "019de52c-fae1-7463-9a7c-d60668eced0d", "version": 1, "description": null }, "framework": null }, "subkind": "headline", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:13:04.2+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "3a232220-5cd0-4b35-a298-a701d01d7394", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [], "arcBeats": [], "loops": [], "locked": true }, { "page": 323, "type": "setup", "title": "The slide uses a 'canary in the coal mine' metaphor to frame the loss of a major customer as a leading indicator of broader market share erosion.", "function": "preempt_rebuttal", "rawType": "preempt_rebuttal", "block": null, "metadata": { "slideType": "preempt_rebuttal", "slideTypeCanon": { "name": "Preempt rebuttal", "slug": "preempt_rebuttal", "status": "active", "canonId": "019de52d-1225-7368-af32-6381fddabdb3", "version": 1, "description": null }, "function": "preempt_rebuttal", "functionCanon": { "name": "Preempt rebuttal", "slug": "preempt_rebuttal", "status": "active", "canonId": "019de52d-18ab-7479-9a7e-820a2f03586a", "version": 1, "description": null }, "density": "dense", "densityScore": 56, "componentCount": 6, "textChars": 3461, "nDataPoints": 0, "notes": "The slide uses a 'canary in the coal mine' metaphor to frame the loss of a major customer as a leading indicator of broader market share erosion.", "elementsJson": [ "paragraph", "callout_box" ], "confidence": 0.95, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:13:05.545+00", "seconds": 8.203, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/323", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-323", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "NRP for DCS's...has the potential to really eat into the overall volume for TransMedics...personally, I feel quite confident that the outcomes are better with NRP than they are with OCS...NRP, I think, is better...and it’s obviously significantly cheaper.", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:25+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5374-767b-b3bd-fb1c69d50fd5", "parentComponentId": null }, { "bbox": { "h": 0.25, "w": 0.86, "x": 0.07, "y": 0.45 }, "kind": "list", "text": "NRP taking off; outcomes are better; OPO's beginning to offer it\nQ: \"Where is that NRP trajectory in the liver community?\"\nA: \"It's a great question, at least when it comes to DCDs because really you only do NRP for DCDs, that has the potential to really eat into the overall volume for TransMedics. Personally, I feel quite confident that the outcomes are better with NRP than they are with OCS...NRP, I think, is better. And it's obviously significantly cheaper. That said, it does require more manpower of some form or another, whether it's on the OPO side or whether it's on the transplant center side, to do the NRP...and we are starting to see OPOs offer their own NRP services. Las Vegas, for example, the OPO in Las Vegas. The OPO in San Francisco, CADN. I know that the OPO in Los Angeles, which is one of the biggest in the country, is starting to roll that out as well. They're getting their own surgeons, so they're going to start offering it. Arizona is offering it as well.\" - Transplant surgeon at a high-volume West Coast academic center", "attrs": null, "canon": { "kind": { "name": "List", "slug": "list", "status": "active", "canonId": "019de52c-f94b-779b-a53b-fd4904a5f4d2", "version": 1, "description": "Bullet or numbered list." }, "tool": null, "subkind": { "name": "Bullet list", "slug": "bullet", "status": "active", "canonId": "019de52c-fc98-7169-a083-5cab805076ca", "version": 1, "description": null }, "framework": null }, "subkind": "bullet", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:13:05.545+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "6da2f731-01d4-407b-9b0c-a2639dfe1c7f", "parentComponentId": null }, { "bbox": { "h": 0.22, "w": 0.86, "x": 0.07, "y": 0.72 }, "kind": "list", "text": "MGH interested in moving to NRP\nA: \"I mentioned other perfusion devices but NRP is an even more salient comparator here....our NRPs have been restricted to very local sites...we've done a handful; we've done a few NRPs.\"\nQ: \"Are you going to shift to NRP or are you kind of slower than some of these other centers?\"\nA: \"It's a great...I think there is a very strong case for changing our business model or changing our economic model to NRP...I think we're going to see NRP just gain in stature and in use, and I think you're going to start seeing real dents in the market share for TransMedics...they can't sustain that kind of cost model, and it really seems haughty...to even think they can get away with the kinds of additional charges that they're pinning on centers.\" - Transplant hepatologist Massachusetts General Hospital", "attrs": null, "canon": { "kind": { "name": "List", "slug": "list", "status": "active", "canonId": "019de52c-f94b-779b-a53b-fd4904a5f4d2", "version": 1, "description": "Bullet or numbered list." }, "tool": null, "subkind": { "name": "Bullet list", "slug": "bullet", "status": "active", "canonId": "019de52c-fc98-7169-a083-5cab805076ca", "version": 1, "description": null }, "framework": null }, "subkind": "bullet", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:13:05.545+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "ba534923-8ccf-4cfe-9030-5fad21e43830", "parentComponentId": null }, { "bbox": { "h": 0.35, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "paragraph", "text": "Some previously large users of TransMedics like Vanderbilt have already eliminated its use after moving to NRP. Other large customers indicated they are on the cusp of adopting NRP. One of TransMedics largest users, with 100 livers per year on OCS, stated NRP is better and cheaper – a canary in the coal mine: \"NRP for DCS's...has the potential to really eat into the overall volume for TransMedics...personally, I feel quite confident that the outcomes are better with NRP than they are with OCS...NRP, I think, is better...and it's obviously significantly cheaper...we are starting to see OPO's offer their own NRP services.\" Massachusetts General stated they've now wetted their beak: \"we've done a few NRP's...there is a very strong case for changing...our economic model to NRP...you're going to start seeing real dents in the market share for TransMedics.\"", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:13:05.545+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "671f6af5-f4a7-461e-9eb2-b38822b45baa", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "“It’s a great question, at least when it comes to DCDs because really you only do NRP for DCDs, that has the potential to really eat into the overall volume for TransMedics. Personally, I feel quite confident that the outcomes are better with NRP than they are with OCS...NRP, I think, is better. And it’s obviously significantly cheaper.” — Transplant surgeon at a high-volume West Coast academic center", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:25+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5374-767b-b3bd-fe367b50bb7d", "parentComponentId": null }, { "bbox": { "h": 0.03, "w": 0.25, "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:13:05.545+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "6466198a-b780-44f0-b67a-04986662b4cf", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [], "arcBeats": [], "loops": [], "locked": true }, { "page": 324, "type": "evidence", "title": "The slide uses direct quotes from industry experts to validate the thesis of NRP market penetration.", "function": "illustrate_case", "rawType": "testimonial", "block": null, "metadata": { "slideType": "testimonial", "slideTypeCanon": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52d-0a2d-7782-8a48-7e84df92cc97", "version": 1, "description": null }, "function": "illustrate_case", "functionCanon": { "name": "Illustrate case", "slug": "illustrate_case", "status": "active", "canonId": "019de52d-13b4-772c-bb73-1873612a7463", "version": 1, "description": null }, "density": "balanced", "densityScore": 48, "componentCount": 6, "textChars": 1353, "nDataPoints": 1, "notes": "The slide uses direct quotes from industry experts to validate the thesis of NRP market penetration.", "elementsJson": [ "paragraph", "quote_block" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:13:05.049+00", "seconds": 7.642, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/324", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-324", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "I just thought that was a dramatic change.", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:25+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5374-767b-b3bd-d1e7c35bff91", "parentComponentId": null }, { "bbox": { "h": 0.12, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "paragraph", "text": "Consistent with the Oct 2024 paper that surveyed 55 OPO’s on their NRP adoption, our interviews indicated OPO’s are rapidly rolling it out to transplant centers in their respective geographies.", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:13:05.049+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "74e731b7-f160-4214-ba3a-0b3363faf830", "parentComponentId": null }, { "bbox": { "h": 0.15, "w": 0.86, "x": 0.07, "y": 0.8 }, "kind": "quote", "text": "we’re just trying to iron out all the kinks before we offer it to more...we’d like to do more NRP cases...I know we’re late to the game...we know of other OPO’s and transplant centers that only use that now.", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:13:05.049+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "17226224-553c-4b82-98d8-27cdf6881619", "parentComponentId": null }, { "bbox": { "h": 0.15, "w": 0.86, "x": 0.07, "y": 0.62 }, "kind": "quote", "text": "Yes, NRP is even cheaper...here in California—there’s an OPO out of Seattle that covers parts of Alaska, Montana...some transplant centers have really figured it out beautifully...in Salt Lake City...they’re got a small, tiny device and a great team.", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:13:05.049+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "e7bc2af3-89fc-4748-bf10-1cbeabd6a618", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "“Yes, NRP is even cheaper...here in California—there’s an OPO out of Seattle that covers parts of Alaska, Montana, you need a big team; you need perfusionists, a really specialized team on top of the transplant surgeons that will need to come in and run the NRP. So, sometimes, there are some transplant centers that have really figured it out beautifully, like Intermountain Medical Center in Salt Lake City. They’ve got a small, tiny device and a great team, and they travel all over the place doing NRP, bringing all their organs in that way.” — Executive at a West Coast OPO, longtime industry veteran", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:25+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5374-767b-b3bd-d763bf8545d9", "parentComponentId": null }, { "bbox": { "h": 0.02, "w": 0.3, "x": 0.07, "y": 0.96 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:13:05.049+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "40057e64-349c-4469-9dbe-bbb02ecac9d7", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [], "arcBeats": [], "loops": [], "locked": true }, { "page": 325, "type": "evidence", "title": "The slide uses a direct quote to frame the current market situation as overpriced and vulnerable to disruption, drawing an analogy to the Hepatitis C drug marke", "function": "cite_precedent", "rawType": "quote_slide", "block": null, "metadata": { "slideType": "quote_slide", "slideTypeCanon": { "name": "Quote slide", "slug": "quote_slide", "status": "active", "canonId": "019de52d-098e-7555-a9fd-4f0af7e80bc2", "version": 1, "description": null }, "function": "cite_precedent", "functionCanon": { "name": "Cite precedent", "slug": "cite_precedent", "status": "active", "canonId": "019de52d-142b-714b-86d4-58aad7b568ec", "version": 1, "description": null }, "density": "balanced", "densityScore": 40, "componentCount": 5, "textChars": 1090, "nDataPoints": 6, "notes": "The slide uses a direct quote to frame the current market situation as overpriced and vulnerable to disruption, drawing an analogy to the Hepatitis C drug market.", "elementsJson": [ "paragraph", "quote_block", "footnote" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:13:02.714+00", "seconds": 5.048, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/325", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-325", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "It is, no question, overpriced...there’s lots of precedence for this sort of stuff happening in the healthcare industry.", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:25+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5374-767b-b3bd-bb6f586ceef8", "parentComponentId": null }, { "bbox": { "h": 0.35, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "paragraph", "text": "A transplant surgeon who heads the program at a leading Northeast academic center stated they’ve already eliminated 1/3 and 1/2 of their TransMedics liver and heart use, respectively, by moving to NRP.", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:13:02.714+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "9ea48256-a2b5-4653-b292-e593e085d016", "parentComponentId": null }, { "bbox": { "h": 0.35, "w": 0.86, "x": 0.07, "y": 0.56 }, "kind": "quote", "text": "Overpriced and being disrupted by new entrants and NRP. \"Why should it cost $70,000-80,000 for disposables? ...there's no question NRP is picking up...it'll be 50/50: half the cases will be with NRP, and half will be with OCS.\"", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:13:02.714+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "48fd09b7-1a81-4bec-bd5b-391a6fe8b778", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "“Why should it cost $70,000-80,000 for disposables? The disposables are essentially plastic tubings and plastic containers and cartridges, and that's more than the cost of a brand-new luxury car that you're paying for a set of things you throw in the garbage, essentially. It is, no question, overpriced...there’s lots of precedence for this sort of stuff happening in the healthcare industry.” — Transplant surgeon and transplant program director at a leading Northeast academic center", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:25+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5374-767b-b3bd-bfa9c9b2a4b7", "parentComponentId": null }, { "bbox": { "h": 0.03, "w": 0.3, "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:13:02.714+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "04d735e5-d0e3-4c8f-8179-c0fabc4d4c7b", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [ { "matchId": "93956342-9354-4eff-9d04-4c3ffa67b27d", "evidence": "Comparing TransMedics pricing to the Hepatitis C drug market (Harvoni).", "framework": null, "confidence": 0.95, "extraction": { "at": "2026-05-02 20:13:02.714+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 325, "frameworkName": "argument-from-analogy" }, { "matchId": "dd7e6d00-70d2-4c67-b7a5-a38b79db5d43", "evidence": "Citing a transplant surgeon to validate market disruption claims.", "framework": null, "confidence": 0.9, "extraction": { "at": "2026-05-02 20:13:02.714+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 325, "frameworkName": "authority-citation" } ], "arcBeats": [], "loops": [], "locked": true }, { "page": 326, "type": "tension", "title": "This slide functions as a 'villain critique' or 'fraud exposure' note, likely part of a short-seller research report.", "function": "name_villain", "rawType": "villain_critique", "block": null, "metadata": { "slideType": "villain_critique", "slideTypeCanon": { "name": "Villain critique", "slug": "villain_critique", "status": "active", "canonId": "019de52d-10bc-7136-bf20-09de59d17447", "version": 1, "description": null }, "function": "name_villain", "functionCanon": { "name": "Name villain", "slug": "name_villain", "status": "active", "canonId": "019de52d-1746-70d6-bc58-5eeaf5865526", "version": 1, "description": null }, "density": "sparse", "densityScore": 11, "componentCount": 3, "textChars": 376, "nDataPoints": 0, "notes": "This slide functions as a 'villain critique' or 'fraud exposure' note, likely part of a short-seller research report.", "elementsJson": [ "paragraph" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:13:02.1+00", "seconds": 4.283, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/326", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-326", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "Surgeons report losing a significant percentage of organs, and allege a cover-up by dishonest management.", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:24+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5374-767b-b3bd-66c6df4d6eea", "parentComponentId": null }, { "bbox": { "h": 0.025, "w": 0.021, "x": 0.896, "y": 0.954 }, "kind": "other", "text": "326", "attrs": null, "canon": { "kind": { "name": "Other", "slug": "other", "status": "active", "canonId": "019de52c-fa90-743c-8bf6-20d1fbe82b6d", "version": 1, "description": "Fallback when no canonical kind applies." }, "tool": null, "subkind": { "name": "Unclassified", "slug": "unclassified", "status": "active", "canonId": "019de52d-05ca-77db-81fb-db7d4234bbc0", "version": 1, "description": null }, "framework": null }, "subkind": "unclassified", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:13:02.1+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "ac096b16-3c51-47fd-b09f-eb493b17a84d", "parentComponentId": null }, { "bbox": { "h": 0.186, "w": 0.854, "x": 0.073, "y": 0.069 }, "kind": "paragraph", "text": "Part 15. TransMedics device is at risk of recall, plagued by what we think is a high failure rate, resulting in necrotic livers with dead tissue and other issues. Surgeons report losing a significant percentage of organs, and allege a cover-up by dishonest management.", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:13:02.1+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "954a2ede-c4ac-4478-8a30-a676b09658f3", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [ { "matchId": "bdb6615b-b9da-44eb-896a-b371777aaabc", "evidence": "The slide explicitly alleges a cover-up and device failure to damage the reputation of the company management.", "framework": null, "confidence": 0.9, "extraction": { "at": "2026-05-02 20:13:02.1+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 326, "frameworkName": "fraud-exposure" } ], "arcBeats": [], "loops": [], "locked": true }, { "page": 327, "type": "tension", "title": "The slide uses direct quotes from former employees to build a case for corporate malfeasance and product failure.", "function": "expose_contradiction", "rawType": "expose_contradiction", "block": null, "metadata": { "slideType": "expose_contradiction", "slideTypeCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-124c-75aa-984a-0a3d0d8fc8df", "version": 1, "description": null }, "function": "expose_contradiction", "functionCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-171f-776f-887c-73edaff4cf9c", "version": 1, "description": null }, "density": "dense", "densityScore": 58, "componentCount": 6, "textChars": 2898, "nDataPoints": 1, "notes": "The slide uses direct quotes from former employees to build a case for corporate malfeasance and product failure.", "elementsJson": [ "paragraph", "quote_block" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:13:03.468+00", "seconds": 5.641, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/327", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-327", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "when it came to reporting, everything was done to basically not report as much as possible.", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:25+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5374-767b-b3bd-e52230488270", "parentComponentId": null }, { "bbox": { "h": 0.23, "w": 0.86, "x": 0.07, "y": 0.72 }, "kind": "list", "text": "Allegedly trying to “not report” safety incidents “as much as possible”\nQ: “There are not many cases reported in MAUDE. Is the company just not reporting them to the FDA?”\nA: “I think there’s a certain number of events that go unreported. Their system is lacking a lot historically in terms of reporting.”\nQ: “Did you ever try to report something and you were told by the CEO or the VP that it doesn’t need to be reported? Were they trying to underreport?”\nA: “Yeah, that was definitely the case...when some malfunction was recognized, everyone was blamed but the device, so the users, the support staff, the engineers and such and such. There was a lot of finger-pointing and blaming...upper management was taking every failure very, very personally. The investigation was very thorough for every case of malfunction. That much I can tell you because I participated in those investigations heavily. But when it came to reporting, everything was done to basically not report as much as possible.” - Former employee in medical safety and clinical affairs", "attrs": null, "canon": { "kind": { "name": "List", "slug": "list", "status": "active", "canonId": "019de52c-f94b-779b-a53b-fd4904a5f4d2", "version": 1, "description": "Bullet or numbered list." }, "tool": null, "subkind": { "name": "Bullet list", "slug": "bullet", "status": "active", "canonId": "019de52c-fc98-7169-a083-5cab805076ca", "version": 1, "description": null }, "framework": null }, "subkind": "bullet", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:13:03.468+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "1be8c99a-1d4a-49b5-ba7f-5ef07289af73", "parentComponentId": null }, { "bbox": { "h": 0.12, "w": 0.86, "x": 0.07, "y": 0.58 }, "kind": "list", "text": "Significant percentage of organs allegedly lost to device failure\n“It was a pretty complex device, so many malfunctions....there were some kinks so the fluids and the gas were not able to flow properly. Some faulty filters...I think it’s between 5-7% of the time, they lose the organ because of a failure.” - Former employee in medical safety and clinical affairs", "attrs": null, "canon": { "kind": { "name": "List", "slug": "list", "status": "active", "canonId": "019de52c-f94b-779b-a53b-fd4904a5f4d2", "version": 1, "description": "Bullet or numbered list." }, "tool": null, "subkind": { "name": "Bullet list", "slug": "bullet", "status": "active", "canonId": "019de52c-fc98-7169-a083-5cab805076ca", "version": 1, "description": null }, "framework": null }, "subkind": "bullet", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:13:03.468+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "7799eff2-a74a-4aca-9f43-baa94c655595", "parentComponentId": null }, { "bbox": { "h": 0.45, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "paragraph", "text": "Ex-employees, surgeons, and OPO’s indicate that TransMedics OCS devices are plagued by failures leading to the loss of a significant percentage of organs; that livers in particular are prone to becoming necrotic, essentially rotting on the device, with dead tissue and parts of livers falling off; that the issues are prevalent enough that customers question why there hasn’t been an FDA recall; and that TransMedics is allegedly engaged in a systematic cover-up by lying to physicians, failing to report device failures to the FDA as required, with the CEO allegedly pressuring employees to doctor safety reports. We begin with an ex-employee in medical safety roles, who stated that “it was a pretty complex device, so many malfunctions...kinks so the fluids and the gas were not able to flow properly...between 5-7% of the time, they lose the organ because of a failure.” The employee indicated a cover-up: “yeah, that was definitely the case...I participated in those investigations heavily...when it came to reporting, everything was done to basically not report as much as possible.”", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:13:03.468+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "b465e78e-aad0-477f-97c4-67a47d78f7d7", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "“it was a pretty complex device, so many malfunctions...kinks so the fluids and the gas were not able to flow properly...between 5-7% of the time, they lose the organ because of a failure.” — Former employee in medical safety and clinical affairs", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:25+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5374-767b-b3bd-eb7753fd8a0c", "parentComponentId": null }, { "bbox": { "h": 0.03, "w": 0.3, "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:13:03.468+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "76412113-d2ba-4a43-b452-46454577b2a7", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [ { "matchId": "b0f02f9c-1216-43bb-af84-e8e114a38bab", "evidence": "The slide systematically presents allegations of regulatory non-compliance and cover-ups.", "framework": null, "confidence": 0.9, "extraction": { "at": "2026-05-02 20:13:03.468+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 327, "frameworkName": "fraud-exposure" } ], "arcBeats": [], "loops": [], "locked": true }, { "page": 328, "type": "tension", "title": "The slide uses a Q&A format to present testimony, highlighting specific instances of alleged misconduct.", "function": "expose_contradiction", "rawType": "expose_contradiction", "block": null, "metadata": { "slideType": "expose_contradiction", "slideTypeCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-124c-75aa-984a-0a3d0d8fc8df", "version": 1, "description": null }, "function": "expose_contradiction", "functionCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-171f-776f-887c-73edaff4cf9c", "version": 1, "description": null }, "density": "dense", "densityScore": 55, "componentCount": 7, "textChars": 1518, "nDataPoints": 0, "notes": "The slide uses a Q&A format to present testimony, highlighting specific instances of alleged misconduct.", "elementsJson": [ "paragraph", "quote_block" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:13:02.825+00", "seconds": 4.94, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/328", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-328", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "When we asked if the CEO was the one pushing to conceal device/safety events, the ex-employee stated “yeah, yeah, absolutely” and alleged “a lot of changes” to replace compliance-minded staff with more amenable ones.", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:25+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5374-767b-b3be-21a994dab360", "parentComponentId": null }, { "bbox": { "h": 0.45, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "paragraph", "text": "When we asked if the CEO was the one pushing to conceal device/safety events, the ex-employee stated “yeah, yeah, absolutely” and alleged “a lot of changes” to replace compliance-minded staff with more amenable ones...", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:13:02.825+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "415484be-38f4-406e-a621-319c9bc30602", "parentComponentId": null }, { "bbox": { "h": 0.22, "w": 0.86, "x": 0.07, "y": 0.71 }, "kind": "quote", "text": "Q: “Were you ever stopped from reporting something by him?” A: “I was asked to consistently phrase stuff differently... he said I don't like what you wrote here... he'd be like, well, you need to write here that this death is not device-related.”", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:13:02.825+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "a068131a-4bbf-4e64-b673-73d3df2fb7f2", "parentComponentId": null }, { "bbox": { "h": 0.12, "w": 0.86, "x": 0.07, "y": 0.58 }, "kind": "quote", "text": "Q: “Was it the CEO saying device malfunction or safety incidents don't need to be reported?” A: “Yeah, yeah, absolutely... he's one of those crazy visionaries who cannot take criticism. That is absolutely a correct assessment.”", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:13:02.825+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "fd378d2c-5651-495b-802d-ff90f595f9e4", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "“I was asked to consistently phrase stuff differently, especially safety. I had meetings with Waleed on multiple occasions when he said I don’t like what you wrote here because it’s finger-pointing. Why don’t we just try to rephrase it? It went through cycles and cycles of editing until he was satisfied... When I was writing my narrative, he’d be like, well, you need to write here that this death is not device-related.” — Former employee in medical safety and clinical affairs", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:25+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5374-767b-b3be-24f97b23dff5", "parentComponentId": null }, { "bbox": { "h": 0.02, "w": 0.3, "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:13:02.825+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "7680a69b-18c9-4d3d-86ea-3e31582b8944", "parentComponentId": null }, { "bbox": { "h": 0.03, "w": 0.85, "x": 0.07, "y": 0.55 }, "kind": "title", "text": "CEO allegedly pressuring staff to doctor and cover up device safety reports", "attrs": null, "canon": { "kind": { "name": "Title", "slug": "title", "status": "active", "canonId": "019de52c-f7dd-76d9-b848-b1f12bd85cf4", "version": 1, "description": "Slide title or headline." }, "tool": null, "subkind": { "name": "Headline", "slug": "headline", "status": "active", "canonId": "019de52c-fae1-7463-9a7c-d60668eced0d", "version": 1, "description": null }, "framework": null }, "subkind": "headline", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:13:02.825+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "810a8afc-9f26-45fe-8371-9ad42bb979bd", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [ { "matchId": "5c807abe-4086-45fd-b4d8-ef7ff5a212f3", "evidence": "The slide presents testimony alleging systematic manipulation of safety data to deceive regulators.", "framework": null, "confidence": 0.9, "extraction": { "at": "2026-05-02 20:13:02.825+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 328, "frameworkName": "fraud-exposure" } ], "arcBeats": [], "loops": [], "locked": true }, { "page": 329, "type": "tension", "title": "The slide uses a Q&A transcript format to substantiate claims about corporate governance and safety oversight failures.", "function": "expose_contradiction", "rawType": "expose_contradiction", "block": null, "metadata": { "slideType": "expose_contradiction", "slideTypeCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-124c-75aa-984a-0a3d0d8fc8df", "version": 1, "description": null }, "function": "expose_contradiction", "functionCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-171f-776f-887c-73edaff4cf9c", "version": 1, "description": null }, "density": "dense", "densityScore": 50, "componentCount": 5, "textChars": 3296, "nDataPoints": 0, "notes": "The slide uses a Q&A transcript format to substantiate claims about corporate governance and safety oversight failures.", "elementsJson": [ "paragraph", "quote_block" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:13:05.139+00", "seconds": 7.251, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/329", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-329", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "The ex-employee further alleged that TransMedics has no safety function or even one person in such a role, and that the VP of Global Regulatory Affairs featured on its management team is just “an ornament because she worked at the FDA before...she was never in the office...she was never in the office...she was not really involved with anything...she had never been to Boston...she was living in Washington, DC...she was not really engaged with any of us...we didn't know where she was or what she was doing.”", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:26+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5374-767b-b3be-48ac371ece4e", "parentComponentId": null }, { "bbox": { "h": 0.45, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "paragraph", "text": "The ex-employee further alleged that TransMedics has no safety function or even one person in such a role, and that the VP of Global Regulatory Affairs featured on its management team is just “an ornament because she worked at the FDA before...she was never in the office...she was never really involved with anything...she had never been to Boston...she was living in Washington, DC...she was not really engaged with any of us...we didn’t know where she was or what she was doing.” The ex-employee further alleged that TransMedics had only one person in a safety role but terminated the entire function: “I still talk to a few people at the company...they do not have a safety person...they haven’t hired anyone...it was a one-person operation...doing all safety for all trials and devices.” We conducted a brief LinkedIn search to check, which showed ~900 employees but none with a profile consistent with such a safety role; the search did indicate a handful of clinical and regulatory affairs employees, albeit without any detail suggesting that their roles encompassed safety.", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:13:05.139+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "7442fed4-5d7c-466c-88e5-2e73ad1171b1", "parentComponentId": null }, { "bbox": { "h": 0.38, "w": 0.86, "x": 0.07, "y": 0.55 }, "kind": "paragraph", "text": "VP of Regulatory Affairs is allegedly just “an ornament”\nA: “Especially the vice president of regulatory, she was hired, but she was more, so to speak, an ornament because she worked at the FDA before. So, you know, to be able to say on their website that so-and-so used to be at the FDA. But she was never in the office. She may be close to 70 years old, but maybe they were just using her name. She was not really involved with anything. She had never been in Boston. She was living in Washington, DC.”\nQ: “Was she on calls? Was she working? Was she interacting with you or no?”\nA: “Not really. And she was not really engaged with any of us.”\nQ: “Was she working with the CEO?”\nA: “No idea. We didn’t know where she was or what she was doing… I still talk to a few people at the company. They do not have a safety person. They haven’t hired anyone. They haven’t replaced that position.”\nQ: “You said they let go the entire safety team?”\nA: “It was one person. It was a one-person operation who was doing all safety for all trials and all devices.”\nQ: “They only had one safety person the entire time?”\nA: “Yeah.” – Former employee in a regulatory affairs role", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:13:05.139+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "ae039f66-de09-40e6-b9f5-8bcd298af535", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "“Especially the vice president of regulatory, she was hired, but she was more, to speak, an ornament because she worked at the FDA before. So, you know, to be able to say on their website that so-and-so used to be at the FDA. But she was never in the office. She may be close to 70 years old, but maybe they were just using her name. She was not really involved with anything. She had never been in Boston. She was living in Washington, DC.” — Former employee in a regulatory affairs role", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:26+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5374-767b-b3be-4de9e45fbfa5", "parentComponentId": null }, { "bbox": { "h": 0.02, "w": 0.3, "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:13:05.139+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "a3e71dd6-81dd-4099-864d-5507070c970c", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [], "arcBeats": [], "loops": [], "locked": true }, { "page": 330, "type": "tension", "title": "The slide uses direct quotes from former employees and industry peers to build a case against the reliability of the TransMedics OCS device.", "function": "expose_contradiction", "rawType": "expose_contradiction", "block": null, "metadata": { "slideType": "expose_contradiction", "slideTypeCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-124c-75aa-984a-0a3d0d8fc8df", "version": 1, "description": null }, "function": "expose_contradiction", "functionCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-171f-776f-887c-73edaff4cf9c", "version": 1, "description": null }, "density": "balanced", "densityScore": 31, "componentCount": 5, "textChars": 814, "nDataPoints": 1, "notes": "The slide uses direct quotes from former employees and industry peers to build a case against the reliability of the TransMedics OCS device.", "elementsJson": [ "paragraph", "quote_block" ], "confidence": 0.95, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:13:02.761+00", "seconds": 4.827, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/330", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-330", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "I don't think the patient outcomes were as good; they had actually one of the worst outcomes.", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:25+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5374-767b-b3be-0c4e1be2a0b5", "parentComponentId": null }, { "bbox": { "h": 0.5, "w": 0.86, "x": 0.07, "y": 0.45 }, "kind": "list", "text": "Centers allegedly stopped using the device due to device problems", "attrs": null, "canon": { "kind": { "name": "List", "slug": "list", "status": "active", "canonId": "019de52c-f94b-779b-a53b-fd4904a5f4d2", "version": 1, "description": "Bullet or numbered list." }, "tool": null, "subkind": { "name": "Bullet list", "slug": "bullet", "status": "active", "canonId": "019de52c-fc98-7169-a083-5cab805076ca", "version": 1, "description": null }, "framework": null }, "subkind": "bullet", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:13:02.761+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "7200dae7-6d2d-49ce-9836-0cd3719b7bb7", "parentComponentId": null }, { "bbox": { "h": 0.35, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "paragraph", "text": "A medical director at OrganOx - which markets a nearly identical FDA-approved normothermic perfusion pump - indicated the device problems were even more widespread at 10-20% of transplant cases...", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:13:02.761+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "254f84be-1870-4b62-9108-6fe2fc34b2ab", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "“one recurrent theme that I seem to be hearing about...is the reliability of these machines...while an organ is on a machine, things can go very, very wrong...I’ve seen maybe...10-20% have some sort of issue...if we had to discard an organ due to a machine error, that gets reported full stop...it’s take a very loud voice to do that...I don’t know if TransMedics has that.” — Medical director at OrganOx", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:25+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5374-767b-b3be-1000d391a30c", "parentComponentId": null }, { "bbox": { "h": 0.03, "w": 0.3, "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:13:02.761+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "cac7ee3d-797a-4c22-a77d-7fae3962047a", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [ { "matchId": "d704ba21-8efe-4c0e-911f-e40cac0fbbf2", "evidence": "The slide systematically presents negative testimonials to challenge the company's public claims.", "framework": null, "confidence": 0.9, "extraction": { "at": "2026-05-02 20:13:02.761+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 330, "frameworkName": "fraud-exposure" } ], "arcBeats": [], "loops": [], "locked": true }, { "page": 331, "type": "tension", "title": "Includes a direct quote from a CEO of a major OPO regarding a surgeon's resignation due to safety concerns.", "function": "expose_contradiction", "rawType": "expose_contradiction", "block": null, "metadata": { "slideType": "expose_contradiction", "slideTypeCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-124c-75aa-984a-0a3d0d8fc8df", "version": 1, "description": null }, "function": "expose_contradiction", "functionCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-171f-776f-887c-73edaff4cf9c", "version": 1, "description": null }, "density": "dense", "densityScore": 50, "componentCount": 5, "textChars": 3148, "nDataPoints": 0, "notes": "Includes a direct quote from a CEO of a major OPO regarding a surgeon's resignation due to safety concerns.", "elementsJson": [ "paragraph", "quote_block", "footnote" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:13:03.797+00", "seconds": 5.774, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/331", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-331", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "One of the most serious issues – which came up repeatedly in our interviews – is livers becoming necrotic on the device, a known risk specific to normothermic perfusion machines like TransMedics but which our research indicates is far more widespread than known – with surgeons alleging a cover-up by the company.", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:26+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5374-767b-b3be-ada168e31745", "parentComponentId": null }, { "bbox": { "h": 0.45, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "paragraph", "text": "One of the most serious issues – which came up repeatedly in our interviews – is livers becoming necrotic on the device, a known risk specific to normothermic perfusion machines like TransMedics but which our research indicates is far more widespread than known – with surgeons alleging a cover-up by the company, a refusal to publish related safety data, and raising the need for a device recall. For reasons we shall explain, liver tissue begins to die and renders the organ unusable, or leads to poor outcomes in the recipient. We were first alerted to the issue by the CEO of a large OPO, who stated TransMedics was trying to keep it “hush-hush” and that he knew a TransMedics procurement surgeon who refused to use the device because it was killing liver tissue - and resigned: “have you heard about the concerns around necrotic tissue on the liver when it goes on a TransMedics device?...when they put the liver on it, it’s almost upside down...concern as there were a couple of livers where this pressure was too high...the tissue was necrotic – it was dying...it was kept pretty hush-hush...I heard about it though a surgeon that used to do recoveries for them...he refused to do it...he’s like, ‘I’m not doing recovery for TransMedics anymore...he left.”", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:13:03.797+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "a4c77c6c-8c68-49b4-84c2-19e956a35181", "parentComponentId": null }, { "bbox": { "h": 0.25, "w": 0.86, "x": 0.07, "y": 0.65 }, "kind": "quote", "text": "Have you heard about the concerns around the necrotic tissue on the liver when it goes on a TransMedics device? When they put the liver on it, it’s almost upside down... some of the tissue was necrotic - it was dying. But I think it was kept pretty hush-hush... he refused to do it. He’s like, ‘I’m not doing recovery for TransMedics anymore,’ because I guess when you’re doing recoveries for them, you have to sign an agreement that says you’ll never recover an organ in any other way than - as opposed to normothermic perfusion.", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:13:03.797+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "3d3b0a7d-4506-408c-af5b-d721a954ce00", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "“Have you heard about the concerns around the necrotic tissue on the liver when it goes on a TransMedics device? When they put the liver on it, it’s almost upside down, and there’s some concern as there were a couple of livers where the pressure was too high and with the warm ischemic - or the normothermic perfusion and the pressure, that some of the tissue was necrotic on the outside of the liver - it was dying. But I think it was kept pretty hush-hush, and they blamed the surgeon and said they didn’t put it on the device correctly. I heard about it through a surgeon that used to do recoveries for them, and then, ultimately, he refused to do it. He’s like, ‘I’m not doing recovery for TransMedics anymore,’ because I guess when you’re doing recoveries for them, you have to sign an agreement that says you’ll never recover an organ in any other way than - as opposed to normothermic perfusion.” — CEO of a major OPO (Organ Procurement Organization), longtime industry executive", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:26+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5374-767b-b3be-b1d0110d4499", "parentComponentId": null }, { "bbox": { "h": 0.03, "w": 0.3, "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:13:03.797+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "2b995d02-601a-4914-ab1b-8d2ce868eced", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [], "arcBeats": [], "loops": [], "locked": true }, { "page": 332, "type": "tension", "title": "The slide presents a Q&A format to highlight a specific technical failure mode (necrosis) attributed to the device's design.", "function": "expose_contradiction", "rawType": "villain_critique", "block": null, "metadata": { "slideType": "villain_critique", "slideTypeCanon": { "name": "Villain critique", "slug": "villain_critique", "status": "active", "canonId": "019de52d-10bc-7136-bf20-09de59d17447", "version": 1, "description": null }, "function": "expose_contradiction", "functionCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-171f-776f-887c-73edaff4cf9c", "version": 1, "description": null }, "density": "dense", "densityScore": 55, "componentCount": 6, "textChars": 3241, "nDataPoints": 0, "notes": "The slide presents a Q&A format to highlight a specific technical failure mode (necrosis) attributed to the device's design.", "elementsJson": [ "paragraph", "quote_block", "footnote" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:13:05.123+00", "seconds": 6.217, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/332", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-332", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": { "h": 0.03, "w": 0.86, "x": 0.07, "y": 0.41 }, "kind": "callout", "text": "TransMedics pump “scrunches” organs into a small area and results in necrotic livers", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": null, "subkind": { "name": "Primary callout", "slug": "primary", "status": "active", "canonId": "019de52c-fbd1-70eb-a9ce-8997f8674c1d", "version": 1, "description": null }, "framework": null }, "subkind": "primary", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:13:05.123+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "cb4d09a9-c2c8-44e1-ae64-ea8d351b327a", "parentComponentId": null }, { "bbox": null, "kind": "callout", "text": "it happens even more with TransMedics...it doesn't have enough blood supply...the reservoir....can be tight or the liver can be under pressure...a portion of the liver can get necrotic before or after transplant...if it happens after transplant, the outcome could be bad...it's reported only in the normothermic machine...I know for sure that happened...I don't know how many times....I know for sure that it happens.", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:26+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5374-767b-b3be-5cfd7497af5b", "parentComponentId": null }, { "bbox": { "h": 0.45, "w": 0.86, "x": 0.07, "y": 0.45 }, "kind": "paragraph", "text": "Q: “[Redacted – CEO of major OPO] mentioned the issue of liver necropsy where the liver is upside down. He said there’s an indentation and they lost some livers because of it. He stated you didn’t want to be involved with the device anymore because it had some issues. I don’t know if that’s accurate, What is the issue?”\nA: “The reservoir that holds the liver, sometimes the liver can be big, and it’s just scrunched into a small area, and with the other machine, it happens even more than with TransMedics; a portion of this liver is necrotic - it doesn’t have enough blood supply and gets necrotic. The reservoir of the liver itself, where they put the liver in the machine, can be tight, or the liver can be under pressure. And a portion of the liver can get necrotic before or after transplant. Before transplant, that’s unfortunate, but you can’t always tell from looking at the liver. If it happens after transplant, the outcome could be bad. It’s reported only in the normothermic machines. I know for sure that happened. I don’t know how many times...I know for sure that it happens.” – Transplant procurement surgeon previously working with TransMedics", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:13:05.123+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "2f234fc0-8955-4ce0-a051-edeec3b06a43", "parentComponentId": null }, { "bbox": { "h": 0.35, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "paragraph", "text": "We then spoke to this former TransMedics procurement surgeon, who provided some of the most damaging color on the company’s practices, as detailed in other chapters. He stated livers become necrotic as the machine’s reservoir “scrunches” them into a small container: ““it happens even more with TransMedics...it doesn’t have enough blood supply...the reservoir....can be tight or the liver can be under pressure...a portion of the liver can get necrotic before or after transplant...if it happens after transplant, the outcome could be bad...it’s reported only in the normothermic machine...I know for sure that happened...I don’t know how many times....I know for sure that it happens.”", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:13:05.123+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "7f94ef50-1b5b-45b6-b9f1-4342aeae03ed", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "“The reservoir that holds the liver, sometimes the liver can be big, and it’s just scrunched into a small area, and with the other machine, it happens even more than with TransMedics; a portion of this liver is necrotic - it doesn’t have enough blood supply and gets necrotic. The reservoir of the liver itself, where they put the liver in the machine, can be tight, or the liver can be under pressure. And a portion of the liver can get necrotic before or after transplant. Before transplant, that’s unfortunate, but you can’t always tell from looking at the liver. If it happens after transplant, the outcome could be bad. It’s reported only in the normothermic machines. I know for sure that happened. I don’t know how many times…I know for sure that it happens.” — Transplant procurement surgeon previously working with TransMedics", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:26+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5374-767b-b3be-61eb941bee90", "parentComponentId": null }, { "bbox": { "h": 0.02, "w": 0.3, "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:13:05.123+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "21efa856-2283-4921-829d-7dc3be59d988", "parentComponentId": null } ], "metrics": [], "tools": [ { "tool": { "name": "Villain slide", "slug": "villain-slide", "status": "active", "bestFor": "In activist decks where the personality matters", "canonId": "019dd9e1-518c-7404-976a-5be5a517b659", "version": 1, "bodyDocId": null, "description": "A dedicated slide presenting the named villain visually", "familyLabel": null, "categoryName": null, "categorySlug": null }, "agent": null, "layer": "slide", "agents": null, "matchId": "cafca373-9102-4107-b244-e85ea7229779", "evidence": "The slide presents a critical view of TransMedics, highlighting damaging information about their practices.", "pageRefs": null, "priority": null, "whenToUse": "In activist decks where the personality matters", "confidence": 0.9, "extraction": { "at": "2026-07-16 23:10:45.025461+00", "model": "or:meta-llama/llama-4-scout", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 332, "whyItWorks": "Makes the antagonist concrete", "antipattern": null, "cardinality": null, "narrativePurpose": null } ], "frameworks": [], "arcBeats": [], "loops": [], "locked": true }, { "page": 333, "type": "tension", "title": "The slide uses visual evidence (images of livers and CT scans) to support the argument that machine perfusion causes lasting tissue damage.", "function": "expose_contradiction", "rawType": "expose_contradiction", "block": null, "metadata": { "slideType": "expose_contradiction", "slideTypeCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-124c-75aa-984a-0a3d0d8fc8df", "version": 1, "description": null }, "function": "expose_contradiction", "functionCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-171f-776f-887c-73edaff4cf9c", "version": 1, "description": null }, "density": "balanced", "densityScore": 46, "componentCount": 6, "textChars": 1490, "nDataPoints": 0, "notes": "The slide uses visual evidence (images of livers and CT scans) to support the argument that machine perfusion causes lasting tissue damage.", "elementsJson": [ "paragraph", "photo", "callout_box" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:13:03.154+00", "seconds": 4.11, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/333", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-333", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "While the clinical literature on normothermic perfusion-induced liver necrosis is lacking – and surgeons told us TransMedics is refusing to publish the data even though they’ve pushed - we note a handful of papers that reference “cradle signs” that appear on livers from being jammed into a pump.", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:25+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5374-767b-b3be-37b0adc1c151", "parentComponentId": null }, { "bbox": { "h": 0.22, "w": 0.86, "x": 0.07, "y": 0.65 }, "kind": "image", "text": "Visual evidence of cradle signs on livers and CT scans", "attrs": null, "canon": { "kind": { "name": "Image", "slug": "image", "status": "active", "canonId": "019de52c-f978-701f-a720-51d029d769e7", "version": 1, "description": "Photo, illustration, screenshot or icon." }, "tool": null, "subkind": { "name": "Photo", "slug": "photo", "status": "active", "canonId": "019de52c-fd37-757f-b4a8-ca26d4888875", "version": 1, "description": null }, "framework": null }, "subkind": "photo", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:13:03.154+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "f479f455-aaea-4700-b9ba-4eef40ff172e", "parentComponentId": null }, { "bbox": { "h": 0.38, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "paragraph", "text": "While the clinical literature on normothermic perfusion-induced liver necrosis is lacking – and surgeons told us TransMedics is refusing to publish the data even though they’ve pushed - we note a handful of papers that reference “cradle signs” that appear on livers from being jammed into a pump. Images A and B (middle) both show the noticeable compressions marks immediately after perfusion. Image B (far right) shows the persistence of compression injury post-transplant, as the latticed indentations are visible on a CT scan of the recipient. The couple of papers on the topic attempt to downplay its significance, but are dated and prior to wider adoption of perfusion – in contrast to current color from the TransMedics ex-surgeon, and other surgeons whom we shortly detail, which indicated the seriousness of the issue.", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:13:03.154+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "9e2a2200-6915-4309-af14-117427692a4f", "parentComponentId": null }, { "bbox": { "h": 0.04, "w": 0.68, "x": 0.07, "y": 0.93 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts; https://journals.lww.com/transplantjournal/fulltext/2021/02000/Machine_Perfusion_Leaving_Its_Mark_on_Liver_34.aspx?context=LatestArticles", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:13:03.154+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "72acb854-6087-49c2-8fd9-bf6f853f8cc0", "parentComponentId": null }, { "bbox": { "h": 0.03, "w": 0.55, "x": 0.07, "y": 0.47 }, "kind": "title", "text": "Clinical literature on \"cradle signs\" from machine perfusion", "attrs": null, "canon": { "kind": { "name": "Title", "slug": "title", "status": "active", "canonId": "019de52c-f7dd-76d9-b848-b1f12bd85cf4", "version": 1, "description": "Slide title or headline." }, "tool": null, "subkind": { "name": "Action title", "slug": "action-title", "status": "active", "canonId": "019de52c-fb31-734c-a0f5-a3935b73135d", "version": 1, "description": null }, "framework": null }, "subkind": "action-title", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:13:03.154+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "951f6a04-2081-49e7-9919-c46246559616", "parentComponentId": null }, { "bbox": { "h": 0.04, "w": 0.55, "x": 0.07, "y": 0.51 }, "kind": "title", "text": "Machine Perfusion—Leaving Its Mark on Liver Transplantation", "attrs": null, "canon": { "kind": { "name": "Title", "slug": "title", "status": "active", "canonId": "019de52c-f7dd-76d9-b848-b1f12bd85cf4", "version": 1, "description": "Slide title or headline." }, "tool": null, "subkind": { "name": "Headline", "slug": "headline", "status": "active", "canonId": "019de52c-fae1-7463-9a7c-d60668eced0d", "version": 1, "description": null }, "framework": null }, "subkind": "headline", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:13:03.154+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "e1d1a3b5-66e2-4deb-9fb2-e068b95933b0", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [ { "matchId": "62cc08f4-61c0-4a6b-8557-ebd3cd2fa566", "evidence": "The slide explicitly contrasts manufacturer claims with expert testimony and visual evidence of physical damage.", "framework": null, "confidence": 0.9, "extraction": { "at": "2026-05-02 20:13:03.154+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 333, "frameworkName": "fraud-exposure" } ], "arcBeats": [], "loops": [], "locked": true }, { "page": 334, "type": "tension", "title": "The slide uses a combination of narrative summary and direct Q&A excerpts to build a case against the company's product claims.", "function": "name_villain", "rawType": "villain_critique", "block": null, "metadata": { "slideType": "villain_critique", "slideTypeCanon": { "name": "Villain critique", "slug": "villain_critique", "status": "active", "canonId": "019de52d-10bc-7136-bf20-09de59d17447", "version": 1, "description": null }, "function": "name_villain", "functionCanon": { "name": "Name villain", "slug": "name_villain", "status": "active", "canonId": "019de52d-1746-70d6-bc58-5eeaf5865526", "version": 1, "description": null }, "density": "dense", "densityScore": 72, "componentCount": 8, "textChars": 3687, "nDataPoints": 0, "notes": "The slide uses a combination of narrative summary and direct Q&A excerpts to build a case against the company's product claims.", "elementsJson": [ "paragraph", "quote_block", "footnote" ], "confidence": 0.95, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:13:09.075+00", "seconds": 9.201, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/334", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-334", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": { "h": 0.03, "w": 0.5, "x": 0.07, "y": 0.51 }, "kind": "callout", "text": "Injury to livers accelerates rapidly after long duration on the pump", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": null, "subkind": { "name": "Primary callout", "slug": "primary", "status": "active", "canonId": "019de52c-fbd1-70eb-a9ce-8997f8674c1d", "version": 1, "description": null }, "framework": null }, "subkind": "primary", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:13:09.075+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "143d84c5-1492-4ef6-a595-5621801623bf", "parentComponentId": null }, { "bbox": { "h": 0.03, "w": 0.35, "x": 0.07, "y": 0.82 }, "kind": "callout", "text": "Infection risk from extended perfusion time", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": null, "subkind": { "name": "Primary callout", "slug": "primary", "status": "active", "canonId": "019de52c-fbd1-70eb-a9ce-8997f8674c1d", "version": 1, "description": null }, "framework": null }, "subkind": "primary", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:13:09.075+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "d949bea1-9526-4eef-8f73-e9f11653fd9b", "parentComponentId": null }, { "bbox": null, "kind": "callout", "text": "The risk is exacerbated as livers are kept on the pump for 10-40 hours – far longer than the few hours in the pivotal trial – while surgeons “get their beauty sleep.”", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:26+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5374-767b-b3be-dec0554859d5", "parentComponentId": null }, { "bbox": { "h": 0.1, "w": 0.86, "x": 0.07, "y": 0.85 }, "kind": "paragraph", "text": "“Infection risk increases the longer this thing is not transplanted. For example, if you’re going to transplant something from Nevada to Seattle or vice versa or a very long distance, that’s when these kinds of limitations come into play where transporting it becomes a bit of a logistical nightmare. Purely from a surgical point of view, there are some concerns there...The liver itself is more sensitive to that than other organ systems.” – Medical director at at OrganOx", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:13:09.075+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "cc578b7b-3772-480a-8e05-2674c6ad6f2b", "parentComponentId": null }, { "bbox": { "h": 0.45, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "paragraph", "text": "The risk is exacerbated as livers are kept on the pump for 10-40 hours – far longer than the few hours in the pivotal trial – while surgeons “get their beauty sleep.” TransMedics recklessly appears to promote the device as capable of keeping livers going for days, with an ex-employee even making claims akin to quackery, suggesting organs are regenerating and “healing.” A medical director at OrganOx expressed alarm at the risk of extended perfusion times – similar to various surgeons we interviewed who have declined to use the device: “to put it mildly, a lot of different things are going to happen clinically to that organ...if you have blood doing through very, very small tubing...that is not healthy...these plastic tubes...red blood cells lyse and cause hemolysis...enzymes will leak out of the liver...all of these markers are essentially early markers of liver failure...increasing at a very high rate if the liver is on for an extend period”; “infection risk increases the longer this thing is not transplanted....”", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:13:09.075+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "d2a96f13-be38-423f-8d07-4a17b8b7d785", "parentComponentId": null }, { "bbox": { "h": 0.25, "w": 0.86, "x": 0.07, "y": 0.55 }, "kind": "paragraph", "text": "Q: “I’ve heard they’re keeping livers on this for a really long time. What risk is there in keeping it for 10-11 hours versus 4 hours?” A: “To put it mildly, a lot of different things are going to happen clinically to that organ. Number one is blood. If you have blood going through very, very small tubing, that is not healthy in the long term. Our own blood vessels are slightly elastic in that they kind of move a little bit. These plastic tubes, which these PRVCs have to move through are more rigid. Because of that, blood, these red blood cells lyse and cause hemolysis and not carry enough oxygen to the organ itself. So, that’s a very real thing that happens with these organ care systems. That’s number one. Then, there is the performance of the liver itself. I talked about transaminase being high. These enzymes will leak out of the liver if it’s sick, and this is a very traumatic thing for a liver to go through. So, it will periodically increase its own transaminase levels and it will show you that it’s not performing well. Similarly, with another biomarker called lactate, that will also increase. All of these are essentially early markers of liver failure...transaminase and lactase are going to start increasing at a very high rate if the liver is on for an extended period of time.” – Medical director at OrganOx", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:13:09.075+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "f1769301-3ca2-405a-b161-40c013be1c4f", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "“to put it mildly, a lot of different things are going to happen clinically to that organ...if you have blood doing through very, very small tubing...that is not healthy...these plastic tubes...red blood cells lyse and cause hemolysis...enzymes will leak out of the liver...all of these markers are essentially early markers of liver failure...increasing at a very high rate if the liver is on for an extend period”; “infection risk increases the longer this thing is not transplanted....” — Medical director at OrganOx", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:26+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5374-767b-b3be-e027d8a0570b", "parentComponentId": null }, { "bbox": { "h": 0.02, "w": 0.3, "x": 0.07, "y": 0.96 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:13:09.075+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "fd557fe7-b068-4e13-8f61-13f4fa99344c", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [], "arcBeats": [], "loops": [], "locked": true }, { "page": 335, "type": "tension", "title": "The slide uses a Q&A format to highlight a specific failure in the procurement process.", "function": "expose_contradiction", "rawType": "testimonial", "block": null, "metadata": { "slideType": "testimonial", "slideTypeCanon": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52d-0a2d-7782-8a48-7e84df92cc97", "version": 1, "description": null }, "function": "expose_contradiction", "functionCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-171f-776f-887c-73edaff4cf9c", "version": 1, "description": null }, "density": "balanced", "densityScore": 37, "componentCount": 5, "textChars": 1256, "nDataPoints": 0, "notes": "The slide uses a Q&A format to highlight a specific failure in the procurement process.", "elementsJson": [ "paragraph", "quote_block" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:13:04.145+00", "seconds": 2.826, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/335", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-335", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "The surgeon indicated that the TransMedics retrieval surgeon was aware of the damage but withheld it – although, as indicated previously, surgeons are prevented from communicating with receiving centers, leading us to think that TransMedics was told but buried it.", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:26+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5374-767b-b3bf-41739671f73d", "parentComponentId": null }, { "bbox": { "h": 0.65, "w": 0.86, "x": 0.07, "y": 0.08 }, "kind": "paragraph", "text": "The Chief of transplant at a center in a major US city provided a recent example of a necrotic liver where “part of the right lobe of the liver was just completely dead” – which the surgeon then realized, after reaching out to colleagues around the country, is a prevalent issue.", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:13:04.145+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "95e7b58e-93f8-4953-af60-4788366b1329", "parentComponentId": null }, { "bbox": { "h": 0.25, "w": 0.86, "x": 0.07, "y": 0.69 }, "kind": "quote", "text": "A: “Examples where it hasn’t gone so great are situations where the liver is on pump. The numbers may be favorable but there’s something we don’t like about the liver. There was a liver a month ago where the right lobe felt very firm, like it was infarction, that part of it had died.”", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:13:04.145+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "fac94887-367d-45f3-9b26-baf108c979c9", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "“Examples where it hasn’t gone so great are situations where the liver is on pump. The numbers may be favorable but there’s something we don’t like about the liver. There was a liver a month ago where the right lobe felt very firm, like it was infarction, that part of it had died.” — Chief of transplant surgery at a major transplant center; high-volume TransMedics users", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:26+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5374-767b-b3bf-46ed879244eb", "parentComponentId": null }, { "bbox": { "h": 0.03, "w": 0.3, "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:13:04.145+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "4281d9f4-fc3f-427d-942a-6cc63c59d3f5", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [ { "matchId": "07a25b0e-8f9b-4993-ade1-4da904fc07e6", "evidence": "Citing a Chief of transplant surgeon to validate claims against TransMedics.", "framework": null, "confidence": 0.9, "extraction": { "at": "2026-05-02 20:13:04.145+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 335, "frameworkName": "authority-citation" } ], "arcBeats": [], "loops": [], "locked": true }, { "page": 336, "type": "tension", "title": "The slide presents a narrative of corporate deception regarding medical device performance.", "function": "expose_contradiction", "rawType": "expose_contradiction", "block": null, "metadata": { "slideType": "expose_contradiction", "slideTypeCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-124c-75aa-984a-0a3d0d8fc8df", "version": 1, "description": null }, "function": "expose_contradiction", "functionCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-171f-776f-887c-73edaff4cf9c", "version": 1, "description": null }, "density": "dense", "densityScore": 61, "componentCount": 7, "textChars": 2516, "nDataPoints": 0, "notes": "The slide presents a narrative of corporate deception regarding medical device performance.", "elementsJson": [ "paragraph", "quote_block", "footnote" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:13:06.906+00", "seconds": 4.381, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/336", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-336", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": { "h": 0.03, "w": 0.86, "x": 0.07, "y": 0.6 }, "kind": "callout", "text": "Failed to report liver was necroscopic; TransMedics allegedly lied to the center to cover up a prevalent issue", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": null, "subkind": { "name": "Primary callout", "slug": "primary", "status": "active", "canonId": "019de52c-fbd1-70eb-a9ce-8997f8674c1d", "version": 1, "description": null }, "framework": null }, "subkind": "primary", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:13:06.906+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "ae8fa858-644d-49dc-8b3c-b24acaeb67a2", "parentComponentId": null }, { "bbox": null, "kind": "callout", "text": "TransMedics allegedly lied to the center to cover up a prevalent issue", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:26+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5374-767b-b3be-f7a5894076c4", "parentComponentId": null }, { "bbox": { "h": 0.52, "w": 0.86, "x": 0.07, "y": 0.08 }, "kind": "paragraph", "text": "The surgeon stated that TransMedics was fully aware that part of the liver was dead, and that they recently encountered another necrotic liver, just weeks after the other one – and that their “Medical Director” Magdy Attia falsely told them they were the only center that had encountered the issue.", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:13:06.906+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "52c19a04-96f5-405d-86cb-0c72fee1a48c", "parentComponentId": null }, { "bbox": { "h": 0.08, "w": 0.86, "x": 0.07, "y": 0.63 }, "kind": "quote", "text": "Q: “So, when you got the liver, you didn’t even know until you felt it and they didn’t tell you?” A: “Until after we felt it, exactly. So, there was an issue and then the liver, the pump - we reported this to TransMedics and we were right. Our concerns were correct.”", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:13:06.906+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "92513c4e-39f4-4f38-8a50-30c0a9a815f9", "parentComponentId": null }, { "bbox": { "h": 0.2, "w": 0.86, "x": 0.07, "y": 0.71 }, "kind": "quote", "text": "Q: “Was this the kind of thing that should have been obvious to the procuring surgeon just by feeling it?” A: “The procuring surgeon could feel it, but it was not reported... Fast forward three weeks later... we inspected the graft more thoroughly... the right lobe of the liver fell off... we called Magdy and the response was ‘Wow, yours is the only center that is having these issues,’ which is an outright lie. There were other centers that definitely had concerns about a graft and how it felt before implantation.”", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:13:06.906+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "dbf28225-12e9-435f-a237-2979dbdf3d91", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "“Until after we felt it, exactly. So, there was an issue and then the liver, the pump - we reported this to TransMedics and we were right. Our concerns were correct.” ... “The procuring surgeon could feel it, but it was not reported. It could have been a procurement issue. But that’s just the first part of the story. Fast forward three weeks later, another colleague, we had another liver on pump for a different patient. And this time because of what happened the previous time, we inspected the graft more thoroughly before we started the operation. And again, this time, the right lobe of the liver fell off. But the numbers, the perfusion numbers were fine. So, we called Magdy and we called TransMedics and we said, ‘The numbers are okay. It looks okay. But that right lobe, we’re nervous because of what happened with our previous patient, and the right lobe doesn’t feel right.’ And then the response was ‘Wow, yours is the only center that is having these issues,’ which is an outright lie. There were other centers that definitely had concerns about a graft and how it felt before implantation.” — Chief of transplant surgery at a major transplant center; high-volume TransMedics user", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:26+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5374-767b-b3be-f9b54bea8a13", "parentComponentId": null }, { "bbox": { "h": 0.02, "w": 0.3, "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:13:06.906+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "4baf33ab-afb5-427e-b933-e36714e4481d", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [ { "matchId": "ba5868b7-2538-47bf-9e38-8f5745c2c011", "evidence": "The slide explicitly frames the content as exposing a lie/cover-up by the company.", "framework": null, "confidence": 0.9, "extraction": { "at": "2026-05-02 20:13:06.906+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 336, "frameworkName": "fraud-exposure" } ], "arcBeats": [], "loops": [], "locked": true }, { "page": 337, "type": "tension", "title": "The slide uses a Q&A format to highlight a perceived cover-up by the company.", "function": "expose_contradiction", "rawType": "expose_contradiction", "block": null, "metadata": { "slideType": "expose_contradiction", "slideTypeCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-124c-75aa-984a-0a3d0d8fc8df", "version": 1, "description": null }, "function": "expose_contradiction", "functionCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-171f-776f-887c-73edaff4cf9c", "version": 1, "description": null }, "density": "dense", "densityScore": 70, "componentCount": 8, "textChars": 2713, "nDataPoints": 0, "notes": "The slide uses a Q&A format to highlight a perceived cover-up by the company.", "elementsJson": [ "paragraph", "quote_block", "footnote" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:13:07.248+00", "seconds": 4.17, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/337", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-337", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "it’s just a fucking lie...it’s a lie that we’re the only center that’s having these problem but that was the communication to us....", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:26+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5374-767b-b3bf-a49f7d51e265", "parentComponentId": null }, { "bbox": { "h": 0.04, "w": 0.86, "x": 0.07, "y": 0.45 }, "kind": "paragraph", "text": "Failed to report liver was necroscopic; TransMedics allegedly lied to the center to cover up a prevalent issue", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:13:07.248+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "33248a97-69a1-4d4e-8eb0-6c860b0e5f31", "parentComponentId": null }, { "bbox": { "h": 0.18, "w": 0.86, "x": 0.07, "y": 0.67 }, "kind": "quote", "text": "A: \"Magdy was the one who told us about that. So, then we called other colleagues around the nation. We called San Diego; we called Washington University in Seattle - what do you guys think? And they said, 'Oh, we've definitely seen that before. Sometimes it's a procurement issue; sometimes it's pressure on the pump. We've definitely seen that before.' So, it's just a fucking lie. It's a lie that we're the only center that's having these problems but that was the communication to us. We don't know what's going on with you guys, but everyone else is fine using our pump. And this situation, we were like, \"You know what? We're not going to put our patient at risk. We'll eat the cost, fine.\" – Chief of transplant surgery at a major transplant center; high-volume TransMedics user", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:13:07.248+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "0dbc8953-bfa9-48bf-9dab-2ace31433093", "parentComponentId": null }, { "bbox": { "h": 0.03, "w": 0.86, "x": 0.07, "y": 0.64 }, "kind": "quote", "text": "Q: \"Who was saying to you you're the only center having this issue and lying? Was that Magdy Attia?\"", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:13:07.248+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "dac52f52-41df-4d44-b7d7-2167384a0a2d", "parentComponentId": null }, { "bbox": { "h": 0.15, "w": 0.86, "x": 0.07, "y": 0.49 }, "kind": "quote", "text": "A: \"So, then their advice to us was, \"Why don't you wait a couple of hours,\" which we did. And the right lobe still didn't feel much better. So, we declined that liver. Fortunate for TransMedics, [transplant center redacted], our colleagues down the road, decided to use that liver for one of their patients. So, that liver did get transplanted. I don't know what the outcome was for their patient but it left a bad taste in our mouth because we are trying to do what's right by our patient and the feedback makes us feel like it's something that we're doing wrong in our assessment....the trust was fractured at that point.\"", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:13:07.248+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "f7003705-55bb-4ac9-812a-ff4861d32fdf", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "“So, then their advice to us was, ‘Why don’t you wait a couple of hours,’ which we did. And the right lobe still didn’t feel much better. So, we declined that liver...the trust was fractured at that point.” ... “Magdy was the one who told us about that. So, then we called other colleagues around the nation...And they said, ‘Oh, we’ve definitely seen that before. Sometimes it’s a procurement issue; sometimes it’s pressure on the pump. We’ve definitely seen that before.’ So, it’s just a fucking lie. It’s a lie that we’re the only center that’s having these problems but that was the communication to us.” — Chief of transplant surgery at a major transplant center; high-volume TransMedics user", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:26+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5374-767b-b3bf-a95096f4eeab", "parentComponentId": null }, { "bbox": { "h": 0.02, "w": 0.3, "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:13:07.248+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "cb4da7cb-03b7-4ce0-940f-349722191521", "parentComponentId": null }, { "bbox": { "h": 0.15, "w": 0.86, "x": 0.07, "y": 0.08 }, "kind": "title", "text": "The surgeon's color suggests a widespread issue with livers becoming necrotic on the device - a known risk and potentially fatal flaw with normothermic perfusion pumps - as well as a conspiracy to cover it up", "attrs": null, "canon": { "kind": { "name": "Title", "slug": "title", "status": "active", "canonId": "019de52c-f7dd-76d9-b848-b1f12bd85cf4", "version": 1, "description": "Slide title or headline." }, "tool": null, "subkind": { "name": "Headline", "slug": "headline", "status": "active", "canonId": "019de52c-fae1-7463-9a7c-d60668eced0d", "version": 1, "description": null }, "framework": null }, "subkind": "headline", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:13:07.248+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "4c1ca31c-79d0-4fa5-b16b-9e867bf219bc", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [], "arcBeats": [], "loops": [], "locked": true }, { "page": 338, "type": "tension", "title": "The slide uses a quote to highlight a perceived lack of transparency by the company.", "function": "expose_contradiction", "rawType": "expose_contradiction", "block": null, "metadata": { "slideType": "expose_contradiction", "slideTypeCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-124c-75aa-984a-0a3d0d8fc8df", "version": 1, "description": null }, "function": "expose_contradiction", "functionCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-171f-776f-887c-73edaff4cf9c", "version": 1, "description": null }, "density": "balanced", "densityScore": 44, "componentCount": 5, "textChars": 1885, "nDataPoints": 0, "notes": "The slide uses a quote to highlight a perceived lack of transparency by the company.", "elementsJson": [ "paragraph", "quote_block", "footnote" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:13:05.662+00", "seconds": 2.494, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/338", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-338", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "TransMedics allegedly refusing to publish data on necrotic livers", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:26+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5374-767b-b3be-c703c5d22684", "parentComponentId": null }, { "bbox": { "h": 0.25, "w": 0.86, "x": 0.07, "y": 0.08 }, "kind": "paragraph", "text": "The surgeon indicated that the two recent livers with necrotic tissue – and the fact that other centers are encountering the same issues – calls for the publication of data about device problems and outcomes, which TransMedics has allegedly refused: \"members of the transplant community, myself included, have called for publication of the livers that are not used or the complications related to livers that have been on the OCS pump, and they declined...TransMedics declined to publish that data...that is not being very honest...it's their responsibility....they should publish it and be forthcoming.\"", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:13:05.662+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "9ade0405-62d1-4d7f-9a50-f150718105e4", "parentComponentId": null }, { "bbox": { "h": 0.25, "w": 0.86, "x": 0.07, "y": 0.39 }, "kind": "quote", "text": "TransMedics allegedly refusing to publish data on necrotic livers\n\"I can't speak to their outcomes overall. But I do know that there are members of the transplant community, myself included, have called for publication of the livers that are not used or the complications related to livers that have been on OCS pump, and they declined. TransMedics declined to publish that data. Like that is not being very honest...it's their responsibility to vet their surgeons and they should publish it and be forthcoming.\" – Chief of transplant surgery at a major Los Angeles transplant center; high volume TransMedics user", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:13:05.662+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "0bdd02ff-21aa-4c8a-b762-86be11a79b36", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "“I can't speak to their outcomes overall. But I do know that there are members of the transplant community, myself included, have called for publication of the livers that are not used or the complications related to livers that have been on OCS pump, and they declined. TransMedics declined to publish that data. Like that is not being very honest...it's their responsibility to vet their surgeons and they should publish it and be forthcoming.” — Chief of transplant surgery at a major Los Angeles transplant center; high volume TransMedics user", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:26+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5374-767b-b3be-cbe10de70d7e", "parentComponentId": null }, { "bbox": { "h": 0.02, "w": 0.3, "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:13:05.662+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "d27d2494-01d9-446b-afa8-9dd7460d1ad6", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [ { "matchId": "a38d810c-643c-4ab1-906b-66dce1424d0a", "evidence": "The slide explicitly frames the company's refusal to publish data as 'not being very honest' and a failure of responsibility.", "framework": null, "confidence": 0.9, "extraction": { "at": "2026-05-02 20:13:05.662+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 338, "frameworkName": "fraud-exposure" } ], "arcBeats": [], "loops": [], "locked": true }, { "page": 339, "type": "tension", "title": "The slide presents a narrative of institutional failure and ethical concerns regarding medical device reporting.", "function": "expose_contradiction", "rawType": "testimonial", "block": null, "metadata": { "slideType": "testimonial", "slideTypeCanon": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52d-0a2d-7782-8a48-7e84df92cc97", "version": 1, "description": null }, "function": "expose_contradiction", "functionCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-171f-776f-887c-73edaff4cf9c", "version": 1, "description": null }, "density": "balanced", "densityScore": 37, "componentCount": 5, "textChars": 1272, "nDataPoints": 0, "notes": "The slide presents a narrative of institutional failure and ethical concerns regarding medical device reporting.", "elementsJson": [ "paragraph", "quote_block", "footnote" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:13:05.584+00", "seconds": 2.252, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/339", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-339", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "people are now saying, are you guys facing the same issues? Am I the only one who’s constantly getting these bombardments of issues left and right without even being notified of these recurring issues or device failures?", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:26+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5374-767b-b3be-754940019a04", "parentComponentId": null }, { "bbox": { "h": 0.25, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "paragraph", "text": "A transplant administrator/executive at Massachusetts General indicated that device problems are widespread, called them “Never Events” of the most urgent nature, questioned why there hasn’t been a recall, and alleged persistent efforts by TransMedics to cover-up device problems and conceal them from the FDA, and blasted the company’s ethics.", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:13:05.584+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "a96c465f-ac99-4066-b9d8-d943dbef777c", "parentComponentId": null }, { "bbox": { "h": 0.38, "w": 0.86, "x": 0.07, "y": 0.55 }, "kind": "quote", "text": "“Bombardments of issues” re device failures and surgical problems Q: “So, you’re referring to never events being surgical, primarily or device failure or a little bit of both?” A: “Both. The example I just shared with you... It’s not fair practice, but it’s also not sound business practice.” – Veteran transplant administrator at Massachusetts General Hospital", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:13:05.584+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "81de6c74-381c-4d7e-b027-a9d9858da4e9", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "“people are now saying, are you guys facing the same issues? Am I the only one who’s constantly getting these bombardments of issues left and right without even being notified of these recurring issues or device failures?” — Veteran transplant administrator at Massachusetts General Hospital", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:26+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5374-767b-b3be-7abb1228ecc3", "parentComponentId": null }, { "bbox": { "h": 0.02, "w": 0.25, "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:13:05.584+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "cfe5cfa5-97d4-4327-84ca-6bee6a24a851", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [], "arcBeats": [], "loops": [], "locked": true }, { "page": 340, "type": "tension", "title": "The slide uses a Q&A format to highlight a specific expert's negative experience with TransMedics equipment and corporate communication.", "function": "expose_contradiction", "rawType": "villain_critique", "block": null, "metadata": { "slideType": "villain_critique", "slideTypeCanon": { "name": "Villain critique", "slug": "villain_critique", "status": "active", "canonId": "019de52d-10bc-7136-bf20-09de59d17447", "version": 1, "description": null }, "function": "expose_contradiction", "functionCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-171f-776f-887c-73edaff4cf9c", "version": 1, "description": null }, "density": "balanced", "densityScore": 42, "componentCount": 5, "textChars": 1646, "nDataPoints": 0, "notes": "The slide uses a Q&A format to highlight a specific expert's negative experience with TransMedics equipment and corporate communication.", "elementsJson": [ "paragraph", "quote_block", "footnote" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:13:06.126+00", "seconds": 2.524, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/340", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-340", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": { "h": 0.03, "w": 0.3, "x": 0.07, "y": 0.44 }, "kind": "callout", "text": "Rampant device failures; covering it up", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": null, "subkind": { "name": "Primary callout", "slug": "primary", "status": "active", "canonId": "019de52c-fbd1-70eb-a9ce-8997f8674c1d", "version": 1, "description": null }, "framework": null }, "subkind": "primary", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:13:06.126+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "a76c759e-9c35-45b2-935c-1ed02f9c102d", "parentComponentId": null }, { "bbox": { "h": 0.35, "w": 0.86, "x": 0.07, "y": 0.47 }, "kind": "quote", "text": "Q: \"How often are you seeing these never issues: device malfunction or surgical errors? Or how often are you hearing about them from other people in the field?\" A: \"Among other people in the field, it's a running joke...\"", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:13:06.126+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "9fb6cc10-bf27-4981-a508-3c95f5aa78b9", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "“Among other people in the field, it’s a running joke. We had a national conference; it’s like, come talk to me about your TransMedics story. It’s laughable. When it comes down to equipment issues, like dealing directly with, let’s say, a malfunction of a panel or blood getting into one of them or something happening to the device mid-flight, but there’s no backup, you can’t flush the organ—I kind of go, ‘What’s your backup?’ And how is there not a backup to the backup as well? And then months go by, and they say, ‘Well, we reviewed it internally. It was a malfunction of the panel. We’re going back and making some changes.’ And I’m going, ‘Okay, so what about all the other devices that are currently out there? Are you going to recall those because of a known issue?’ And then they say, ‘This is actually nothing. It’s outside of the norm of how many we’re doing. There’s a certain defect rate that is allowable, and this does not fall within that defect rate. We’re a trusted partner. We appreciate you.’ That’s the extent of it.” — Veteran transplant administrator at Massachusetts General Hospital", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:26+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5374-767b-b3bf-11fe5af8cf1a", "parentComponentId": null }, { "bbox": { "h": 0.02, "w": 0.3, "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:13:06.126+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "2e55fc3c-a94c-49c4-997e-baa498ef504d", "parentComponentId": null }, { "bbox": { "h": 0.15, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "title", "text": "The MGH executive stated that the device problems are now \"a running joke\" in the transplant field – \"are you going to recall these because of a known issue?\" - and detailed various incidents where TransMedics was evasive", "attrs": null, "canon": { "kind": { "name": "Title", "slug": "title", "status": "active", "canonId": "019de52c-f7dd-76d9-b848-b1f12bd85cf4", "version": 1, "description": "Slide title or headline." }, "tool": null, "subkind": { "name": "Headline", "slug": "headline", "status": "active", "canonId": "019de52c-fae1-7463-9a7c-d60668eced0d", "version": 1, "description": null }, "framework": null }, "subkind": "headline", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:13:06.126+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "f0c5d095-3092-4822-a2b9-fb08d3298e88", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [ { "matchId": "02b1d6be-b7d5-4e3d-97ec-24bbcd540386", "evidence": "The slide explicitly frames the company's behavior as covering up device failures.", "framework": null, "confidence": 0.9, "extraction": { "at": "2026-05-02 20:13:06.126+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "pageNumber": 340, "frameworkName": "fraud-exposure" } ], "arcBeats": [], "loops": [], "locked": true }, { "page": 341, "type": "tension", "title": "The slide highlights a critical failure in safety protocols and regulatory compliance as perceived by an industry expert.", "function": "expose_contradiction", "rawType": "quote_slide", "block": null, "metadata": { "slideType": "quote_slide", "slideTypeCanon": { "name": "Quote slide", "slug": "quote_slide", "status": "active", "canonId": "019de52d-098e-7555-a9fd-4f0af7e80bc2", "version": 1, "description": null }, "function": "expose_contradiction", "functionCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-171f-776f-887c-73edaff4cf9c", "version": 1, "description": null }, "density": "dense", "densityScore": 51, "componentCount": 5, "textChars": 4445, "nDataPoints": 0, "notes": "The slide highlights a critical failure in safety protocols and regulatory compliance as perceived by an industry expert.", "elementsJson": [ "paragraph", "quote_block", "footnote" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:13:07.463+00", "seconds": 3.809, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/341", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-341", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": null, "kind": "callout", "text": "When there are certain never events...under the watch of TransMedics...I’ve been struggling to find anyone who takes ownership of it...to the point where I have to request them to show proof that they self-report to the FDA.", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:27+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5374-767b-b3c0-4607d43fb57a", "parentComponentId": null }, { "bbox": { "h": 0.35, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "paragraph", "text": "The MGH executive indicated that there are not minor malfunctions but “adverse events that should never occur,” calling them “Never Events” in the “highly, highly regulated world of transplants” – such as a failure that could “put the organ at risk or when a recipient will be put under anesthesia waiting for the organ and a device malfunction occurs, and you lose the organ...” He indicated “certain never events” with TransMedics that required that he “be called within a few hours by our governing body and regulatory body, so would my chief compliance officer...either it’s a sentinel event or adverse event”; “when there are certain never events...under the watch of TransMedics...I’ve been struggling to find anyone who takes ownership of it...to the point where I have to request them to show proof that they self-report to the FDA.”", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:13:07.463+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "64b75982-7c57-463b-9155-46798afc1f03", "parentComponentId": null }, { "bbox": { "h": 0.45, "w": 0.86, "x": 0.07, "y": 0.48 }, "kind": "quote", "text": "Never events like losing organs due to device failure or human error; failing to report; called by regulatory bodies\n“Device failure-wise, it just goes along with what I had mentioned before, how any time that there’s even a device failure, any time they could potentially even put the organ at risk or when a recipient will be put under anesthesia waiting for the organ and a device malfunction occurs, and you lose the organ? That’s a never event [...] these are adverse events that should never occur, and, obviously, you’d want to have many different countermeasures, many different plan Bs and Cs that would back things up so that you would never, number one, lose the organ; two, have a situation where either the organ is not procured because of human error or such, or there are delays that were not mitigated. And so, there are certain never events that have occurred where in the highly, highly regulated world of transplants, I would essentially be called within a few hours by our governing body and regulatory body, so would my chief compliance officer, and we’d be on a phone call directly addressing the issue, either it’s a sentinel event or an adverse event and there would be clear processes related to reporting of the event, either self-reporting to the DPH, CMS, OPTN, or UNOS and PFC. And that would happen roughly within 24 hours. When there are certain never events that have occurred under the watch of TransMedics...I’ve been struggling to find anyone who takes ownership of it, anyone who either have self-reports to the FDA or not, and to the point where I have to request them to show proof that they self-report to the FDA.” – Veteran transplant administrator at Massachusetts General Hospital", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:13:07.463+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "5216e126-79f4-4788-ab13-d214569bc1ae", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "“Device failure-wise, it just goes along with what I had mentioned before, how any time that there’s even a device failure, any time they could potentially even put the organ at risk or when a recipient will be put under anesthesia waiting for the organ and a device malfunction occurs, and you lose the organ? That’s a never event [...] these are adverse events that should never occur, and, obviously, you’d want to have many different countermeasures, many different plan Bs and Cs that would back things up so that you would never, number one, lose the organ; two, have a situation where either the organ is not procured because of human error or such, or there are delays that were not mitigated. And so, there are certain never events that have occurred where in the highly, highly regulated world of transplants, I would essentially be called within a few hours by our governing body and regulatory body, so would my chief compliance officer, and we’d be on a phone call directly addressing the issue, either it’s a sentinel event or an adverse event and there would be clear processes related to reporting of the event, either self-reporting to the DPH, CMS, OPTN, or UNOS and PFC. And that would happen roughly within 24 hours. When there are certain never events that have occurred under the watch of TransMedics...I’ve been struggling to find anyone who takes ownership of it, anyone who either self-reports to the FDA or not, and to the point where I have to request them to show proof that they self-report to the FDA.” — Veteran transplant administrator at Massachusetts General Hospital", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:27+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5374-767b-b3c0-483a41ad13d2", "parentComponentId": null }, { "bbox": { "h": 0.03, "w": 0.3, "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:13:07.463+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "a0ea0d12-e2ab-432e-833b-a8d5d84ea33f", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [], "arcBeats": [], "loops": [], "locked": true }, { "page": 342, "type": "tension", "title": "The slide uses highlighted text to emphasize key allegations of non-reporting and unethical behavior.", "function": "expose_contradiction", "rawType": "quote_slide", "block": null, "metadata": { "slideType": "quote_slide", "slideTypeCanon": { "name": "Quote slide", "slug": "quote_slide", "status": "active", "canonId": "019de52d-098e-7555-a9fd-4f0af7e80bc2", "version": 1, "description": null }, "function": "expose_contradiction", "functionCanon": { "name": "Expose contradiction", "slug": "expose_contradiction", "status": "active", "canonId": "019de52d-171f-776f-887c-73edaff4cf9c", "version": 1, "description": null }, "density": "dense", "densityScore": 73, "componentCount": 8, "textChars": 3744, "nDataPoints": 0, "notes": "The slide uses highlighted text to emphasize key allegations of non-reporting and unethical behavior.", "elementsJson": [ "paragraph", "quote_block", "footnote" ], "confidence": 1, "extraction": { "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "at": "2026-05-02 20:13:07.973+00", "seconds": 4.217, "promptVersion": "v2-canon-conditioned" } }, "links": { "slide": "/slides/019dd923-622c-750b-8b9a-40e2965928db/342", "deck": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckAnchor": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-342", "deckJson": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json" }, "components": [ { "bbox": { "h": 0.12, "w": 0.86, "x": 0.07, "y": 0.41 }, "kind": "callout", "text": "Failing to report device malfunction issues known among transplant centers", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": null, "subkind": { "name": "Primary callout", "slug": "primary", "status": "active", "canonId": "019de52c-fbd1-70eb-a9ce-8997f8674c1d", "version": 1, "description": null }, "framework": null }, "subkind": "primary", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:13:07.973+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "77467dbc-3621-4d78-a307-067e19b3ef13", "parentComponentId": null }, { "bbox": { "h": 0.03, "w": 0.86, "x": 0.07, "y": 0.61 }, "kind": "callout", "text": "MGH uncomfortable with lack of FDA reporting for device malfunctions", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": null, "subkind": { "name": "Primary callout", "slug": "primary", "status": "active", "canonId": "019de52c-fbd1-70eb-a9ce-8997f8674c1d", "version": 1, "description": null }, "framework": null }, "subkind": "primary", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:13:07.973+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "eb4899af-4bac-4765-83f8-9141b5c59db6", "parentComponentId": null }, { "bbox": null, "kind": "callout", "text": "I wouldn’t be surprised if it has happened to us or around certain cases that we’ve been involved with.", "attrs": null, "canon": { "kind": { "name": "Callout", "slug": "callout", "status": "active", "canonId": "019de52c-f8d3-761a-8953-7d37080de5e2", "version": 1, "description": "Highlighted callout box." }, "tool": { "name": "Visual emphasis", "slug": "visual-emphasis", "status": "active", "bestFor": null, "canonId": "019dd9e1-474b-736b-a8eb-a794dd88241c", "version": 1, "bodyDocId": null, "description": "Drawing the eye to one element above the rest of the slide.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:26+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5374-767b-b3bf-bdf4167da52f", "parentComponentId": null }, { "bbox": { "h": 0.25, "w": 0.86, "x": 0.07, "y": 0.65 }, "kind": "paragraph", "text": "Q: “It sounds like they’re actively trying to conceal these times when a surgeon messed up, or the device malfunctioned. Have you seen a pattern of concealment or where they’re actually faking or misreporting it? People are telling me that and I’m wondering what you’ve observed directly or heard about.”\nA: “...that one individual feeling pressured or bullied to either redact the report and adjust the content of that, that is, I mean, unethical is not even what I would call it, but I would just call it that for now...what’s sad to say out loud is I wouldn’t be surprised if it has happened to us or around certain cases that we’ve been involved with. As I mentioned before, their response related to self-reporting to the FDA related to the device malfunction didn’t fall within their margin of error; that didn’t seem right to me, and we had to go through some other routes to get that resolved or at least looked at. As I mentioned, when we started this way back when, and it was still awaiting the FDA, we were working with them very hand-in-hand because it did seem like it was a very promising technology. There was a fundamental alignment of our philosophies of what we wanted to do together. That is not the case anymore.” – Veteran transplant administrator at Massachusetts General Hospital", "attrs": null, "canon": { "kind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "5f2affc0-941d-4d07-959d-4bfc1930cea4", "version": 1, "description": "Single prose block in the body of a slide." }, "tool": null, "subkind": { "name": "Paragraph", "slug": "paragraph", "status": "active", "canonId": "019de52c-fb80-75af-aa5c-a7a4bfac2433", "version": 1, "description": null }, "framework": null }, "subkind": "paragraph", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:13:07.973+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "d3919bf6-d512-4945-ad96-247e6bfe75bd", "parentComponentId": null }, { "bbox": { "h": 0.12, "w": 0.86, "x": 0.07, "y": 0.43 }, "kind": "quote", "text": "“There have been situations where they have even stated that they have not needed to report it based on the volume that they have, which to me doesn’t make any sense because these are never events. These are situations where patients are not able to get a life-saving heart because of an issue. And, on top of that, because the transplant world is small, we all talk to each other. We all know what’s going on. And the fact that we know of three or four situations where that’s occurred with other transplant programs, and TransMedics has not even self-reported that. I mean, any type of recall...TransMedics has not done that and I’m a bit taken aback.” – Veteran transplant administrator at Massachusetts General Hospital", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": null, "subkind": { "name": "Testimonial", "slug": "testimonial", "status": "active", "canonId": "019de52c-fc21-71b6-9ac3-8266a64945e8", "version": 1, "description": null }, "framework": null }, "subkind": "testimonial", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:13:07.973+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "c3ac2348-c40d-4ecc-af30-703feab14acc", "parentComponentId": null }, { "bbox": null, "kind": "quote", "text": "“There have been situations where they have even stated that they have not needed to report it based on the volume that they have, which to me doesn’t make any sense because these are never events. These are situations where patients are not able to get a life-saving heart because of an issue. And, on top of that, because the transplant world is small, we all talk to each other. We all know what’s going on. And the fact that we know of three or four situations where that’s occurred with other transplant programs, and TransMedics has not even self-reported that. I mean, any type of recall...TransMedics has not done that and I’m a bit taken aback.” — Veteran transplant administrator at Massachusetts General Hospital", "attrs": null, "canon": { "kind": { "name": "Quote", "slug": "quote", "status": "active", "canonId": "019de52c-f8fb-751e-8bc6-d58e2d59562a", "version": 1, "description": "Pull quote or testimonial." }, "tool": { "name": "Authority citation", "slug": "authority-citation", "status": "active", "bestFor": null, "canonId": "019dd9e1-49ae-7557-89ad-3fca70469b45", "version": 1, "bodyDocId": null, "description": "Quoting an authority figure, study, or precedent to lend weight.", "familyLabel": null }, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-04-22 23:46:26+00", "model": "unknown-legacy", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "019dd953-5374-767b-b3bf-c3e540f62cd5", "parentComponentId": null }, { "bbox": { "h": 0.02, "w": 0.3, "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "canon": { "kind": { "name": "Source note", "slug": "source-note", "status": "active", "canonId": "23484952-494b-4a5e-b1ad-550d0d70e948", "version": 1, "description": "Attribution / source / caveat placed at the slide footer. Numbered footnotes use attrs.numbered." }, "tool": null, "subkind": null, "framework": null }, "subkind": null, "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:13:07.973+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "ee9e2251-9b9d-42da-8c70-c266e6e4ab24", "parentComponentId": null }, { "bbox": { "h": 0.25, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "title", "text": "The MGH executive stated “these are situations where patients are not able to get a life-saving heart because of an issue....because the transplant world is small, we all talk to each other...the fact that we know of three or four situations where that’s occurred with other transplant programs, and TransMedics has not even self-reported that...I mean, any type of recall...TransMedics has not done that and I’m a bit taken aback...their response related to the device malfunction....that didn’t seem right to me...when we started this way back when, and it was still awaiting the FDA, we were working with them hand-in-hand...there was a fundamental alignment...that is not the case anymore.”", "attrs": null, "canon": { "kind": { "name": "Title", "slug": "title", "status": "active", "canonId": "019de52c-f7dd-76d9-b848-b1f12bd85cf4", "version": 1, "description": "Slide title or headline." }, "tool": null, "subkind": { "name": "Headline", "slug": "headline", "status": "active", "canonId": "019de52c-fae1-7463-9a7c-d60668eced0d", "version": 1, "description": null }, "framework": null }, "subkind": "headline", "groupRole": null, "confidence": null, "extraction": { "at": "2026-05-02 20:13:07.973+00", "model": "google/gemini-3.1-flash-lite-preview-20260303", "runId": null, "seconds": null, "promptVersion": null }, "componentId": "5f978c5f-f513-48d8-a64f-1d36c7f941ba", "parentComponentId": null } ], "metrics": [], "tools": [], "frameworks": [], "arcBeats": [], "loops": [], "locked": true } ], "arcBeats": [ { "from": 11, "to": 20, "label": "Critique of TransMedics Group Inc.", "description": "The section presents a critical analysis of TransMedics Group Inc.'s practices and leadership." }, { "from": 12, "to": 30, "label": "Exposure of Contradictions", "description": "The section highlights contradictions in TransMedics Group Inc.'s statements and actions." }, { "from": 3, "to": 9, "label": "Testimonials from Industry Experts", "description": "The section presents testimonials from experts and industry professionals criticizing TransMedics Group Inc." } ], "loops": [] }