{ "docId": "019dd923-622c-750b-8b9a-40e2965928db", "docSlug": "e5bffbaac707", "documentTitle": "TransMedics (TMDX)", "authorId": "58_Scorpion_Capital", "authorName": "Scorpion Capital", "documentKindSlug": "research-note", "documentKindLabel": "Research note", "sourceTypeSlug": "short_seller", "sourceTypeLabel": "Short seller", "presentationDate": "2025-01-10 00:00:00", "orientation": "landscape", "aspectRatio": 1.3333334, "pageNumber": 103, "pageCount": 342, "prevPage": 102, "nextPage": 104, "slideType": "villain_critique", "function": "expose_contradiction", "density": "overcrowded", "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" ], "metadataConfidence": 0.95, "imagePath": null, "slideHref": "/slides/019dd923-622c-750b-8b9a-40e2965928db/103", "deckHref": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckJsonHref": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json", "deckAnchorHref": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-103", "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, "subkind": null, "toolName": "Visual emphasis", "toolSlug": "visual-emphasis", "confidence": null, "componentId": "019dd953-5373-719d-a979-abe20d7193f3", "frameworkName": null, "frameworkSlug": null }, { "bbox": null, "kind": "metric", "text": "customer concentration: 25%", "attrs": null, "subkind": "primary", "toolName": "Quantification", "toolSlug": "quantification", "confidence": null, "componentId": "019dd953-5373-719d-a979-b22fdb5fb0bc", "frameworkName": null, "frameworkSlug": 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, "subkind": "paragraph", "toolName": null, "toolSlug": null, "confidence": null, "componentId": "d2ff338c-8ffc-44d7-bdaa-1c331ea94001", "frameworkName": null, "frameworkSlug": 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, "subkind": "testimonial", "toolName": null, "toolSlug": null, "confidence": null, "componentId": "252319b1-33b9-40da-bf1d-a5cd0d56c180", "frameworkName": null, "frameworkSlug": 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, "subkind": "testimonial", "toolName": null, "toolSlug": null, "confidence": null, "componentId": "33e907bb-36a1-48fc-952e-5c2180b88b67", "frameworkName": null, "frameworkSlug": 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, "subkind": "testimonial", "toolName": null, "toolSlug": null, "confidence": null, "componentId": "dd2e5fbc-ac79-4210-bcca-e8bc96384f29", "frameworkName": null, "frameworkSlug": 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, "subkind": null, "toolName": "Authority citation", "toolSlug": "authority-citation", "confidence": null, "componentId": "019dd953-5373-719d-a979-af414f03cfca", "frameworkName": null, "frameworkSlug": 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, "subkind": null, "toolName": null, "toolSlug": null, "confidence": null, "componentId": "68ff3ed2-dc79-443b-a5c9-9c00a5e520b3", "frameworkName": null, "frameworkSlug": null } ], "metrics": [], "tools": [], "frameworks": [ { "name": "authority-citation", "slug": null, "matchId": "21998245-6a89-420a-85e7-9b98fc496b1b", "evidence": "Uses expert surgeon quotes to validate revenue concentration claims.", "confidence": 0.9 } ], "arcBeats": [], "loops": [], "imagePathAlt": null, "thumbSrc": null, "thumbSrcAlt": null, "locked": true }