{ "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": 222, "pageCount": 239, "prevPage": 221, "nextPage": 223, "slideType": "expose_contradiction", "function": "expose_contradiction", "density": "overcrowded", "nDataPoints": 0, "notes": "Uses testimonial evidence to frame the company's sales practices as unethical and exploitative.", "elementsJson": [ "headline_text", "paragraph", "quote_block", "footnote" ], "metadataConfidence": 1, "imagePath": null, "slideHref": "/slides/019dd923-622c-750b-8b9a-2a2468219173/222", "deckHref": "/decks/019dd923-622c-750b-8b9a-2a2468219173", "deckJsonHref": "/decks/019dd923-622c-750b-8b9a-2a2468219173.json", "deckAnchorHref": "/decks/019dd923-622c-750b-8b9a-2a2468219173#slide-222", "components": [ { "bbox": null, "kind": "callout", "text": "Former Nevro executives and reps suggested that employees game the evaluation to ensure a virtually 100% pass rate.", "attrs": null, "subkind": null, "toolName": "Visual emphasis", "toolSlug": "visual-emphasis", "confidence": null, "componentId": "019dd953-3f3d-76db-b34a-13cd8041dfe1", "frameworkName": null, "frameworkSlug": null }, { "bbox": { "h": 0.25, "w": 0.88, "x": 0.06, "y": 0.13 }, "kind": "paragraph", "text": "Insurers recognize that stimulator patients comprise a vulnerable population at high risk of being exploited into a device. Stimulators are typically a last resort for long-time chronic pain patients, often with multiple failed surgeries, opioid dependence, and the associated psychiatric toll and vulnerabilities. As a result, prior to a stimulator trial, patients are required to undergo a psychiatric evaluation. Former Nevro executives and reps suggested that employees game the evaluation to ensure a virtually 100% pass rate. They painted a disturbing picture of implant recipients who are “not the best stimulator candidates” and would “never pass the psychiatric evaluation”; suicidal patients calling the central support line; and patients complaining that the Nevro rep lied to them about 100% pain relief and a cure.", "attrs": null, "subkind": "paragraph", "toolName": null, "toolSlug": null, "confidence": null, "componentId": "61ca7929-b136-46a4-920e-281776f185fe", "frameworkName": null, "frameworkSlug": null }, { "bbox": { "h": 0.15, "w": 0.88, "x": 0.06, "y": 0.42 }, "kind": "quote", "text": "The chronic pain patient population has a psychiatric toll. It affects 100% of patients. If a patient failed a psychiatric evaluation, the sales rep would send them to another psychiatrist. It’s fair to say they get shopped around. You don’t even need to get shopped around because the psychiatric evaluation is not in depth. It’s a bottleneck for time but not for volumes in the sales funnel.", "attrs": null, "subkind": "testimonial", "toolName": null, "toolSlug": null, "confidence": null, "componentId": "1358e411-2205-4a66-b0d3-994b69721feb", "frameworkName": null, "frameworkSlug": null }, { "bbox": { "h": 0.18, "w": 0.88, "x": 0.06, "y": 0.71 }, "kind": "quote", "text": "We’d get calls from patients, hear their demeanor on the phone, and wonder how they ever got the device. These were not the best stimulator candidates. Our conversations in the call center were with device recipients who were suicidal, folks with really really high and unrealistic expectations. They told me I’d get 100% pain relief, it would cure me, it would go away. The call center would say it’s not true, it’s not a cure. I don’t know if they were oversold by the doctor or rep. Patients had unrealistic expectations of the device and therapy.", "attrs": null, "subkind": "testimonial", "toolName": null, "toolSlug": null, "confidence": null, "componentId": "9101b82d-270c-47a4-977d-3e7fa1710d6e", "frameworkName": null, "frameworkSlug": null }, { "bbox": { "h": 0.06, "w": 0.88, "x": 0.06, "y": 0.61 }, "kind": "quote", "text": "When Nevro’s call center would deal with patients, we’d realize they’d never pass the psychiatric evaluation yet here we are and they have the device.", "attrs": null, "subkind": "testimonial", "toolName": null, "toolSlug": null, "confidence": null, "componentId": "ce352900-c08d-4ca6-8263-2f05793ac3c0", "frameworkName": null, "frameworkSlug": null }, { "bbox": null, "kind": "quote", "text": "\"The chronic pain patient population has a psychiatric toll. It affects 100% of patients. If a patient failed a psychiatric evaluation, the sales rep would send them to another psychiatrist. It’s fair to say they get shopped around. You don’t even need to get shopped around because the psychiatric evaluation is not in depth. It’s a bottleneck for time but not for volumes in the sales funnel.\" — Former Nevro regional sales director for one of its largest territories; \"When Nevro’s call center would deal with patients, we’d realize they’d never pass the psychiatric evaluation yet here we are and they have the device.\" — Former Nevro executive; \"We’d get calls from patients, hear their demeanor on the phone, and wonder how they ever got the device. These were not the best stimulator candidates. Our conversations in the call center were with device recipients who were suicidal, folks with really really high and unrealistic expectations. They told me I’d get 100% pain relief, it would cure me, it would go away. The call center would say it’s not true, it’s not a cure. I don’t know if they were oversold by the doctor or rep. Patients had unrealistic expectations of the device and therapy.\" — Former Nevro executive", "attrs": null, "subkind": null, "toolName": "Authority citation", "toolSlug": "authority-citation", "confidence": null, "componentId": "019dd953-3f3d-76db-b34a-148b013388e2", "frameworkName": null, "frameworkSlug": null }, { "bbox": { "h": 0.02, "w": 0.2, "x": 0.06, "y": 0.96 }, "kind": "source-note", "text": "Source: Consultation calls with experts", "attrs": null, "subkind": null, "toolName": null, "toolSlug": null, "confidence": null, "componentId": "a98b8924-8591-4d9e-9587-20f16a961736", "frameworkName": null, "frameworkSlug": null }, { "bbox": { "h": 0.03, "w": 0.8, "x": 0.06, "y": 0.09 }, "kind": "title", "text": "Over-utilization, unnecessary implants, and patient exploitation are key drivers of Nevro’s sales", "attrs": null, "subkind": "action-title", "toolName": null, "toolSlug": null, "confidence": null, "componentId": "3368eaf4-bce1-44cd-b9ba-49d566bb066a", "frameworkName": null, "frameworkSlug": null }, { "bbox": { "h": 0.03, "w": 0.4, "x": 0.06, "y": 0.04 }, "kind": "title", "text": "Scorpion Capital | Nevro (NYSE: NVRO)", "attrs": null, "subkind": "headline", "toolName": null, "toolSlug": null, "confidence": null, "componentId": "e407602a-9cea-48ad-a31e-5b6c346a2208", "frameworkName": null, "frameworkSlug": null } ], "metrics": [], "tools": [], "frameworks": [ { "name": "fraud-exposure", "slug": null, "matchId": "ff93305b-fa97-4f4e-8451-9a920955bfce", "evidence": "The slide systematically presents evidence of unethical and potentially fraudulent sales practices.", "confidence": 0.9 } ], "arcBeats": [], "loops": [], "imagePathAlt": null, "thumbSrc": null, "thumbSrcAlt": null, "locked": true }