{ "docId": "019dd923-622c-750b-8b9a-2a2468219173", "docSlug": "ce565b841c40", "documentTitle": "Nevro Corp. (NVRO)", "authorId": "58_Scorpion_Capital", "authorName": "Kir Kahlon", "documentKindSlug": "activist-deck", "documentKindLabel": "Activist deck", "sourceTypeSlug": "short_seller", "sourceTypeLabel": "Short seller", "presentationDate": "2021-01-07 00:00:00", "orientation": "landscape", "aspectRatio": 1.3333334, "pageNumber": 20, "pageCount": 239, "prevPage": 19, "nextPage": 21, "slideType": "expose_contradiction", "function": "expose_contradiction", "density": "overcrowded", "nDataPoints": 4, "notes": "The slide uses direct quotes from KOLs to build a narrative of corporate dishonesty and product failure.", "elementsJson": [ "paragraph", "quote_block", "footnote" ], "metadataConfidence": 1, "imagePath": null, "slideHref": "/slides/019dd923-622c-750b-8b9a-2a2468219173/20", "deckHref": "/decks/019dd923-622c-750b-8b9a-2a2468219173", "deckJsonHref": "/decks/019dd923-622c-750b-8b9a-2a2468219173.json", "deckAnchorHref": "/decks/019dd923-622c-750b-8b9a-2a2468219173#slide-20", "components": [ { "bbox": null, "kind": "callout", "text": "The company just lies. They’re full of it.", "attrs": null, "subkind": null, "toolName": "Visual emphasis", "toolSlug": "visual-emphasis", "confidence": null, "componentId": "019dd953-3f3d-76db-b337-48c50427fbbc", "frameworkName": null, "frameworkSlug": null }, { "bbox": { "h": 0.25, "w": 0.9, "x": 0.05, "y": 0.31 }, "kind": "paragraph", "text": "KOL #3 confirmed Nevro's explants problem, having spoken with “hundreds of physicians” as a speaker “Some of the engineers at Boston Scientific went to Nevro. I know a couple of them very well. There was a pretty significant falloff in Nevro usage after the honeymoon...I made the decision that Nevro can't really be used, based on the problems we're seeing. So, the percentage of my implants that are Nevro is zero. None....I can tell you from talking to hundreds of physicians across the United States and internationally, because I did speaking programs internationally, it's about explants. The number of explants that you see...you can do the math. Why doesn't Nevro publish its explant data? We've asked them to do that, and they refused. You put a stimulator in, life is good for a little while. Then the honeymoon's over. Nevro doesn't talk about explant data long-term, and you need that because that's real life.”", "attrs": null, "subkind": "paragraph", "toolName": null, "toolSlug": null, "confidence": null, "componentId": "6d82183e-e8ca-43e9-bf1a-ee78d5a8fff6", "frameworkName": null, "frameworkSlug": null }, { "bbox": { "h": 0.35, "w": 0.9, "x": 0.05, "y": 0.58 }, "kind": "paragraph", "text": "KOL #4 stated that the 33% explant rate in a recent paper is low, and that the actual rate could be 50-60%, “Everything was great for a few months. But then I noticed that for a lot of the patients, the device stopped working after three to six months...And then I noticed that the high frequency started hurting patients.. It went from being great to not working to irritating...The 33% explant rate for Nevro devices [in the NANS paper] is definitely low. It's significantly higher. Patients hate the Nevro device. That thing is a piece of shit. The explant rate could easily be 50-60%. It definitely doesn't work much more often than it does 6-12 months out. The high frequency is causing the nerves to become hypersensitive. The company just lies. They're full of it...I've been implanting for a long time and I rarely explant. Sure, sometimes stimulators don't work. But rarely do they stop working and irritate a patient. I mean, it's happened but not at the numbers we saw with Nevro. I would rarely explant people. I would say 1 or 2%, if that.”", "attrs": null, "subkind": "paragraph", "toolName": null, "toolSlug": null, "confidence": null, "componentId": "70fa9f3e-e4b7-4b82-9d69-3ae251575247", "frameworkName": null, "frameworkSlug": null }, { "bbox": { "h": 0.15, "w": 0.9, "x": 0.05, "y": 0.13 }, "kind": "paragraph", "text": "KOL's #3 and #4 repeated the same, indicating a widespread explants problem with Nevro's device and an actual rate far higher than the 33% finding in a recent NANS paper – potentially 50-60%. One indicated that the high frequency mechanism of action not only failed to provide pain relief, but was “hurting patients” – a finding we shall shortly detail – and causing “the nerves to become hypersensitive”: “The company just lies. They're full of it.”", "attrs": null, "subkind": "paragraph", "toolName": null, "toolSlug": null, "confidence": null, "componentId": "f2925746-f067-4171-8fd8-a0d96aa2fef6", "frameworkName": null, "frameworkSlug": null }, { "bbox": null, "kind": "quote", "text": "I can tell you from talking to hundreds of physicians across the United States and internationally, because I did speaking programs internationally, it's about explants. — KOL #3; The device stopped working after three to six months...It went from being great to not working to irritating...The 33% explant rate for Nevro devices [in the NANS paper] is definitely low. It’s significantly higher. Patients hate the Nevro device. That thing is a piece of shit. — KOL #4", "attrs": null, "subkind": null, "toolName": "Authority citation", "toolSlug": "authority-citation", "confidence": null, "componentId": "019dd953-3f3d-76db-b337-4ef43b3d97dd", "frameworkName": null, "frameworkSlug": null }, { "bbox": { "h": 0.02, "w": 0.2, "x": 0.05, "y": 0.96 }, "kind": "source-note", "text": "Source: Consultation calls with experts", "attrs": null, "subkind": null, "toolName": null, "toolSlug": null, "confidence": null, "componentId": "434e4a1d-fd23-49f5-9cee-d65e35498222", "frameworkName": null, "frameworkSlug": null }, { "bbox": { "h": 0.03, "w": 0.4, "x": 0.05, "y": 0.04 }, "kind": "title", "text": "Scorpion Capital | Nevro (NYSE: NVRO)", "attrs": null, "subkind": "headline", "toolName": null, "toolSlug": null, "confidence": null, "componentId": "a434153d-aa7b-4290-a221-c9b2933b2669", "frameworkName": null, "frameworkSlug": null }, { "bbox": { "h": 0.02, "w": 0.2, "x": 0.05, "y": 0.09 }, "kind": "title", "text": "1. Introduction to Nevro", "attrs": null, "subkind": "subtitle", "toolName": null, "toolSlug": null, "confidence": null, "componentId": "9ce46969-a8a6-493b-96bd-3e2910cdfb5f", "frameworkName": null, "frameworkSlug": null } ], "metrics": [], "tools": [ { "name": "Rhetorical figure", "slug": "rhetorical-figure", "agent": null, "layer": "slide", "matchId": "21a8d7d7-17cc-4fa5-8737-70cf2f4b4332", "evidence": "The use of rhetorical devices, such as metaphors or analogies, helps to emphasize the problems.", "confidence": 0.7 } ], "frameworks": [ { "name": "fraud-exposure", "slug": null, "matchId": "de7b17a5-94f0-4226-ac45-c1a77b852855", "evidence": "The slide uses expert testimony to allege that the company is lying about product performance data.", "confidence": 0.9 } ], "arcBeats": [ { "to": 20, "from": 9, "beatId": "531dd341-6a18-4138-9808-503ee7f0f77f", "arcName": "Overcoming the Monster", "arcSlug": "overcoming-monster", "beatName": "The Monster", "beatSlug": "overcoming-monster-the-monster", "evidence": "The deck presents a series of criticisms and contradictions against Nevro", "position": 0, "confidence": 0.8, "parentBeatName": "Hook", "parentBeatSlug": "hook" } ], "loops": [ { "to": 20, "from": 10, "name": "The Reveal", "slug": "05-the-reveal", "bestFor": "Product launches, strategic pivots, unexpected findings", "matchId": "c6d7ccb1-a71b-4960-8866-cbf6a13f3065", "evidence": "The deck presents a series of contradictions and criticisms against Nevro", "position": 0, "objective": "Reveal Nevro's flaws", "structure": "Setup the Question -> Build Suspense -> The Big Reveal", "confidence": 0.8, "description": "Build mystery and anticipation, then deliver a surprising or powerful conclusion" } ], "imagePathAlt": null, "thumbSrc": null, "thumbSrcAlt": null, "locked": true }