{ "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": 163, "pageCount": 342, "prevPage": 162, "nextPage": 164, "slideType": "expose_contradiction", "function": "expose_contradiction", "density": "overcrowded", "nDataPoints": 0, "notes": "The slide uses direct quotes to expose a misalignment between the stated value proposition (reduced hospitalization) and the actual usage (scheduling convenience).", "elementsJson": [ "paragraph", "callout_box" ], "metadataConfidence": 1, "imagePath": null, "slideHref": "/slides/019dd923-622c-750b-8b9a-40e2965928db/163", "deckHref": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckJsonHref": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json", "deckAnchorHref": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-163", "components": [ { "bbox": { "h": 0.03, "w": 0.86, "x": 0.07, "y": 0.71 }, "kind": "callout", "text": "Only benefit is “scheduling convenience”; surgeons misleading hospitals into “perceiving” reduced hospitalization", "attrs": null, "subkind": "primary", "toolName": null, "toolSlug": null, "confidence": null, "componentId": "a5fee188-e18f-46d7-808b-1a186f1bbf9a", "frameworkName": null, "frameworkSlug": null }, { "bbox": { "h": 0.03, "w": 0.86, "x": 0.07, "y": 0.51 }, "kind": "callout", "text": "Surgeons are “real blunt” in admitting the usage is only for scheduling convenience", "attrs": null, "subkind": "primary", "toolName": null, "toolSlug": null, "confidence": null, "componentId": "f64d9674-f856-419a-9c49-cb80c67eabfb", "frameworkName": null, "frameworkSlug": null }, { "bbox": null, "kind": "callout", "text": "the main and perhaps only value proposition was scheduling convenience.", "attrs": null, "subkind": null, "toolName": "Visual emphasis", "toolSlug": "visual-emphasis", "confidence": null, "componentId": "019dd953-5373-719d-a97e-1df4c9fe4288", "frameworkName": null, "frameworkSlug": null }, { "bbox": { "h": 0.25, "w": 0.86, "x": 0.07, "y": 0.22 }, "kind": "paragraph", "text": "One of TransMedics highest-volume users implied that surgeons are manipulating administrators with purported benefits: “I will freely admit that most surgeons are using mostly subjective criteria” and that they wrongly attribute any “perceived” benefit to the device” – “the biggest cheerleader for this is a busy surgeon who doesn’t want to come in at 2AM…of course, when you go say [reduced hospitalization] to the hospital system, they love that…the main and perhaps only value proposition was scheduling convenience.” A second surgeon, who leads a major transplant program in Pennsylvania, was crystal clear: “delaying cases for the morning is true…let me real blunt…when we do this, it’s for the operating room team to start at the normal time at 7:30 in the morning…do some centers use it on everyone when they don’t need to? Absolutely correct and absolute fact.”", "attrs": null, "subkind": "paragraph", "toolName": null, "toolSlug": null, "confidence": null, "componentId": "28d59069-4cfb-4e43-b69c-9300dd303700", "frameworkName": null, "frameworkSlug": null }, { "bbox": { "h": 0.18, "w": 0.86, "x": 0.07, "y": 0.75 }, "kind": "paragraph", "text": "Q: “What really is the value proposition? If 75% to 80% of livers are still within the region, is it really a benefit from spending $100,000 versus doing it the traditional way with cold storage?” A: “So, now you can pump a liver, a liver that historically you would not use based on - I will freely admit most surgeons are using mostly subjective criteria for what is a good organ or not….and so, they attribute mostly right, but somewhat wrongly subjectively the benefit from all this to the device. The biggest cheerleader for this is a busy surgeon who doesn’t want to come in at 2AM, would rather come at 8 in the morning and do a transplant, perceives that utilization of these devices reduces the hospitalization - of course, when you go say that to the hospital system, they love that…the main and perhaps only value proposition was scheduling convenience.” - Transplant hepatologist and director of the liver program at a Midwest academic center; one of", "attrs": null, "subkind": "paragraph", "toolName": null, "toolSlug": null, "confidence": null, "componentId": "e61db2a3-4a7c-4659-bcb1-6879ff39dfe9", "frameworkName": null, "frameworkSlug": null }, { "bbox": { "h": 0.12, "w": 0.86, "x": 0.07, "y": 0.55 }, "kind": "quote", "text": "“Delaying cases for the morning is true - let me be real blunt. You have to beg the nurses to come in and pay them a lot of money and anesthesia, the same way. In fact, some of the anesthesia people will quit after a while because they don’t want to work all night. So, when we do this, it’s for the operating room team to start at the normal time, at 7:30 in the morning…So, do some centers use it on everyone when they don’t need to? Absolutely correct and absolute fact.” - Transplant surgeon and transplant program director at a major academic center in Pennsylvania", "attrs": null, "subkind": "testimonial", "toolName": null, "toolSlug": null, "confidence": null, "componentId": "f3dcdae8-b129-45e9-9586-d21e385a43f7", "frameworkName": null, "frameworkSlug": null }, { "bbox": null, "kind": "quote", "text": "“Delaying cases for the morning is true - let me be real blunt. You have to beg the nurses to come in and pay them a lot of money and anesthesia, the same way. In fact, some of the anesthesia people will quit after a while because they don't want to work all night. So, when we do this, it's for the operating room team to start at the normal time, at 7:30 in the morning...So, do some centers use it on everyone when they don't need to? Absolutely correct and absolute fact.” — Transplant surgeon and transplant program director at a major academic center in Pennsylvania", "attrs": null, "subkind": null, "toolName": "Authority citation", "toolSlug": "authority-citation", "confidence": null, "componentId": "019dd953-5373-719d-a97e-218c76ce767c", "frameworkName": null, "frameworkSlug": null }, { "bbox": { "h": 0.02, "w": 0.3, "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": "e4553989-783e-44c3-b714-f6a4a481b1d3", "frameworkName": null, "frameworkSlug": null }, { "bbox": { "h": 0.15, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "title", "text": "We have never heard surgeons – or any physicians – so openly confess that their usage is for non-clinical, off-label reasons.", "attrs": null, "subkind": "headline", "toolName": null, "toolSlug": null, "confidence": null, "componentId": "cdba026c-7d34-4ee9-867d-4bebe5562094", "frameworkName": null, "frameworkSlug": null } ], "metrics": [], "tools": [], "frameworks": [ { "name": "fraud-exposure", "slug": null, "matchId": "7e5d7336-00e8-4acc-82b6-6878c5f507b8", "evidence": "The slide explicitly exposes a gap between the stated clinical value and the actual usage for convenience, framing it as a deceptive practice.", "confidence": 0.9 } ], "arcBeats": [], "loops": [], "imagePathAlt": null, "thumbSrc": null, "thumbSrcAlt": null, "locked": true }