{ "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": 95, "pageCount": 239, "prevPage": 94, "nextPage": 96, "slideType": "testimonial", "function": "illustrate_case", "density": "overcrowded", "nDataPoints": 4, "notes": "The slide uses a 'case study' format to provide qualitative evidence of product failure.", "elementsJson": [ "headline_text", "paragraph", "quote_block", "footnote" ], "metadataConfidence": 0.95, "imagePath": null, "slideHref": "/slides/019dd923-622c-750b-8b9a-2a2468219173/95", "deckHref": "/decks/019dd923-622c-750b-8b9a-2a2468219173", "deckJsonHref": "/decks/019dd923-622c-750b-8b9a-2a2468219173.json", "deckAnchorHref": "/decks/019dd923-622c-750b-8b9a-2a2468219173#slide-95", "components": [ { "bbox": null, "kind": "callout", "text": "The 33% explant rate in the NANS paper is massively underreported and that the actual rate is “tremendous” and possibly 50-60%; that Nevro’s reps couldn’t get the devices to work again; that the device harms patients; that Nevro “just lies”.", "attrs": null, "subkind": null, "toolName": "Visual emphasis", "toolSlug": "visual-emphasis", "confidence": null, "componentId": "019dd953-3f3d-76db-b33e-86e80aecb863", "frameworkName": null, "frameworkSlug": null }, { "bbox": { "h": 0.25, "w": 0.9, "x": 0.05, "y": 0.14 }, "kind": "paragraph", "text": "As additional corroboration, we share five detailed case studies of KOL's, each of whom was initially excited by Nevro's device only to experience an explant crisis, and who provided remarkably consistent and damning feedback about Nevro's technology and conduct. We begin with case study #1: a high volume implanter who described his initial experience with Nevro as \"almost miraculous,\" only to sour after seeing rampant failures within 3-6 months. He states that the 33% explant rate in the NANS paper is massively underreported and that the actual rate is \"tremendous\" and possibly 50-60%; that Nevro's reps couldn't get the devices to work again; that the device harms patients; that Nevro \"just lies\"; and that he's never seen anything like this with other stimulators. He bluntly stated that \"patients hate the Nevro device\" and that it's a \"piece of shit.\"", "attrs": null, "subkind": "paragraph", "toolName": null, "toolSlug": null, "confidence": null, "componentId": "43885398-54ad-47ec-938f-634f91894f2f", "frameworkName": null, "frameworkSlug": null }, { "bbox": { "h": 0.08, "w": 0.9, "x": 0.05, "y": 0.56 }, "kind": "quote", "text": "The reps would then come out and go through their very rigid algorithm. And most of them couldn't get the implants working again. And then I noticed that the high frequency started hurting patients.. It went from being great to not working to irritating.", "attrs": null, "subkind": "testimonial", "toolName": null, "toolSlug": null, "confidence": null, "componentId": "032ee275-0f89-4afa-a08e-df7faec68c05", "frameworkName": null, "frameworkSlug": null }, { "bbox": { "h": 0.12, "w": 0.9, "x": 0.05, "y": 0.42 }, "kind": "quote", "text": "I worked with Nevro for a while, but I had a bad experience with them. When they first released [in the US] they had a study from Australia that showed that they were head over heels better than the other stimulators. I started implanting them, and it was almost miraculous. Patients loved it. 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.", "attrs": null, "subkind": "testimonial", "toolName": null, "toolSlug": null, "confidence": null, "componentId": "0c64f39a-31eb-46d0-a039-a42fc45d9202", "frameworkName": null, "frameworkSlug": null }, { "bbox": { "h": 0.1, "w": 0.9, "x": 0.05, "y": 0.8 }, "kind": "quote", "text": "I've worked with others to study their explant rate, because it's tremendous. 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.\" -High volume implanter and KOL", "attrs": null, "subkind": "testimonial", "toolName": null, "toolSlug": null, "confidence": null, "componentId": "6e7edb7a-f7f2-4a7d-8998-749be415af27", "frameworkName": null, "frameworkSlug": null }, { "bbox": { "h": 0.12, "w": 0.9, "x": 0.05, "y": 0.66 }, "kind": "quote", "text": "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.", "attrs": null, "subkind": "testimonial", "toolName": null, "toolSlug": null, "confidence": null, "componentId": "78aaa0f7-8367-4517-bd3d-6628f9b8ec14", "frameworkName": null, "frameworkSlug": null }, { "bbox": null, "kind": "quote", "text": "“I worked with Nevro for a while, but I had a bad experience with them... Patients hate the Nevro device. That thing is a piece of shit. The explant rate could easily be 50-60%... The company just lies. They're full of it.” — High volume implanter and KOL", "attrs": null, "subkind": null, "toolName": "Authority citation", "toolSlug": "authority-citation", "confidence": null, "componentId": "019dd953-3f3d-76db-b33e-8a7438c11c06", "frameworkName": null, "frameworkSlug": null }, { "bbox": { "h": 0.02, "w": 0.2, "x": 0.05, "y": 0.95 }, "kind": "source-note", "text": "Source: Consultation calls with experts", "attrs": null, "subkind": null, "toolName": null, "toolSlug": null, "confidence": null, "componentId": "98e5de4e-e85e-4c57-9d6b-a0bb86f82107", "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": "667087e9-3899-48e0-ab3c-7abe8f1faf1b", "frameworkName": null, "frameworkSlug": null }, { "bbox": { "h": 0.04, "w": 0.9, "x": 0.05, "y": 0.09 }, "kind": "title", "text": "7. Nevro's explants crisis is pervasive yet unknown to most investors: case studies of 5 KOL's", "attrs": null, "subkind": "headline", "toolName": null, "toolSlug": null, "confidence": null, "componentId": "ecf15ed8-4a58-40b5-a313-36b80bbe3f28", "frameworkName": null, "frameworkSlug": null } ], "metrics": [], "tools": [], "frameworks": [], "arcBeats": [ { "to": 150, "from": 51, "beatId": "903c076a-f368-4ca1-844c-277874c1afb2", "arcName": "Overcoming the Monster", "arcSlug": "overcoming-monster", "beatName": "The Victory", "beatSlug": "overcoming-monster-the-victory", "evidence": "The deck presents a conclusion that Nevro's problems are insurmountable", "position": 2, "confidence": 0.8, "parentBeatName": "Turn", "parentBeatSlug": "turn" } ], "loops": [], "imagePathAlt": null, "thumbSrc": null, "thumbSrcAlt": null, "locked": true }