{ "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": 128, "pageCount": 342, "prevPage": 127, "nextPage": 129, "slideType": "expose_contradiction", "function": "expose_contradiction", "density": "dense", "nDataPoints": 0, "notes": "The slide presents anecdotal evidence of systemic gaming of the organ allocation system.", "elementsJson": [ "paragraph", "quote_block", "footnote" ], "metadataConfidence": 1, "imagePath": null, "slideHref": "/slides/019dd923-622c-750b-8b9a-40e2965928db/128", "deckHref": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckJsonHref": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json", "deckAnchorHref": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-128", "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, "subkind": "primary", "toolName": null, "toolSlug": null, "confidence": null, "componentId": "29a75557-d0b2-426f-93ff-a6b9f17abeea", "frameworkName": null, "frameworkSlug": null }, { "bbox": null, "kind": "callout", "text": "There’s a lot of game-playing going on out there.", "attrs": null, "subkind": null, "toolName": "Visual emphasis", "toolSlug": "visual-emphasis", "confidence": null, "componentId": "019dd953-5373-719d-a97a-7ea324435ccd", "frameworkName": null, "frameworkSlug": 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, "subkind": "paragraph", "toolName": null, "toolSlug": null, "confidence": null, "componentId": "e8d03c3b-2cda-4334-a3a6-3063a3023330", "frameworkName": null, "frameworkSlug": 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, "subkind": "testimonial", "toolName": null, "toolSlug": null, "confidence": null, "componentId": "6f4634c8-d54c-4f1d-8780-3345ef73600f", "frameworkName": null, "frameworkSlug": 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, "subkind": null, "toolName": "Authority citation", "toolSlug": "authority-citation", "confidence": null, "componentId": "019dd953-5373-719d-a97a-82adbb35389e", "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": "a643153e-a826-412a-8996-aebda80b01d2", "frameworkName": null, "frameworkSlug": null } ], "metrics": [], "tools": [], "frameworks": [], "arcBeats": [], "loops": [], "imagePathAlt": null, "thumbSrc": null, "thumbSrcAlt": null, "locked": true }